New Patients

If you are a new patient to our Pinole Shores Dental office, the files below will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Thank you and please call our office @ 510-724-5100, if you have any questions.

Children & Adult Welcome/Registration Forms (2 pages)

Childrens Medical Forms (2 pages)

Adult Medical Forms (2 pages)


This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.