Downloadable Forms For You, Our Patient
Below are forms you may need for your visit. If you have any questions please call us:
650-583-5880
• New Patient Welcome Package - Meet Dr. Tsai and her team
• New Patient Information Form - Adult 
• New Patient Information Form - Child 
• Office Policies & HIPPA Form 
• X-Ray Request Form - send to your previous Dentist 
Sleep Apnea Related Forms
• New Patient Information Form - Adult 
• Office Policies & HIPPA Form 
• Sleep Apnea Self Evaluation
• Oral Appliance Referral & Medical Necessity Form 
• CPAP Intolerance Affidavit 
• Clinical Limitations of Oral Appliance Therapy 
• Oral Appliance Therapy Consent Form 
• Somnomed Warranty Card
• Somnomed Adjustment Instructions
If there are any other forms or information we can provide please send us an e-mail or give us a call:650-583-5880
New Dental Patient and Sleep Apnea Forms at Millbrae Dental Care
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