Patient Forms

New patient? Please download and fill out ALL the following forms :

New Patient's Form
Adobe Acrobat document [80.4 KB]
Health History Form - Part 1
Adobe Acrobat document [456.4 KB]
Health History Form - Part 2
Adobe Acrobat document [413.0 KB]
Treatment Consent
Treatment Consent.pdf
Adobe Acrobat document [229.1 KB]
Visit Needs Checklist
Adobe Acrobat document [502.2 KB]
Our Financial Policy
NEW FA (1).jpeg
JPG image [650.4 KB]

Privacy Notice

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy. This form should also be brought to your first appointment.

Privacy Notice
Adobe Acrobat document [214.9 KB]

 Or call us today at:



Peninsula Dental Care

1122 Hopkins Ave

Redwood City, CA 94062

Fax: (650) 556-1122



Use our contact form to get in touch.

Office Hours

Mon 9 AM - 6 PM

Tue 9 AM - 6 PM


Thr 9 AM - 6 PM

Fri  7 AM- 4 PM

Outside our regular business hours, please note our Dental Emergency Care information.

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Keep Your Teeth Healthy!

What is the best preventive care for your teeth? Find out how to make your next visit easier and more pleasant.

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