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New Patient Forms

If you would like to fill out your NEW PATIENT FORMS before your appointment, please print the following 3 forms.  If you do not know some of the answers, leave it blank and Dr. Kitagawa will address it during your appointment.
New Patient Registration Form
Medical History Form
Dental History Form
For children under 12 years old please fill out the Child History Form instead of the New Pateint Registration Form, Dental History Form and Medical History Form.
Child History Form