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Smiles Forever

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    • Dr Alex Targ MD
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San Jose – Dental Care & Forms

Directions

373 South Monroe Suite 203 San Jose CA 95128

Patients going to “San Jose” office, kindly complete the forms below:

  1. Patient insurance form

  2. Medical history

  3. Dental treatment consent

  4. HIPAA information

  5. Financial policy agreement

  6. HIPAA acknowledgment

  7. Covid 19 Patient screening (Please use doctor email: smileydoctor@gmail.com)

Appointment:

Please take the appointment using here:  appointment with Dr. Reena Gupta


You can pay using any below:

  • Zelle: smileydoctor@gmail.com / 650-965-2929
  • Venmo:  smileydoctor
  • Paypal : https://paypal.me/smileydoctor

Paper Forms (Only used when the patient is in the clinic): 

  • Smiley Doctor – Dental Health History Form

  • Smiley Doctor – Dental Medical Evaluation Form

  • Smiley Doctor – Transfer of Records Form

 

PAGES

  • Home
  • Our Doctors
    • Dr Reena Gupta DDS
    • Dr Alex Targ MD
    • Dr Amy Fanhua Meng DMD
    • Dr Chirag Patel DDS
    • Dr Aaditi Mujumdar DDS
  • Services
    • Our Services
    • Testimonials
    • Awards
    • Insurances
  • Forms
    • Antioch
    • San Jose
  • Appointment

TIMINGS

Monday 9AM–5PM

Tuesday 8AM–5PM

Wednesday 9AM–5PM

Thursday 9AM–5PM

Friday 9AM–5PM

Saturday 9AM–5PM

Sunday Closed

WHY THEY LOVE US

https://www.smileydoctor.com/wp-content/uploads/2017/12/video01.mp4

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