2225 Buchanan Rd STE A, Antioch, CA 94509
Web Forms – Please fill these forms before your appointment
- Patient insurance form
- Medical history
- Dental treatment consent
- HIPAA information
- Financial policy agreement
- HIPAA acknowledgment
Appointment:
Please take the appointment by calling 925-727-3141
OR
Click here: Appointment at Smileydoctor Dental Clinic Antioch
You can pay using any below:
- Zelle: smileydoctor@gmail.com / 650-965-2929
- Venmo: smileydoctor ((Please give 4 digits as 2672 if venmo asks )
- Paypal : https://paypal.me/smileydoctor
Paper Forms (Only used when the patient is in the clinic):
- Smiley Doctor – Dental Health History Form
- Smiley Doctor – Medical Evaluation Form
- Smiley Doctor – Transfer of Records Form