(562) 988-0148 3960 Atlantic Avenue, Long Beach, CA 90807

Patient Forms

For your convenience, you may print out the any of the patient forms listed below and fill them out at your own pace, from the comfort of your own home. Then just fax them to us or bring them in with you when you visit us for your scheduled dental appointment.

Patient Registration Form

Patient Medical History

Smile Questionnaire

Records Release Form

HIPPA Privacy Statement

HIPAA Consent Form

© 2019 Copyright by Greg Campbell D.D.S. All Rights Reserved.