We would like to encourage you to try our Modento Mobile App, available for Android and iPhone! Once registered, you will be able to complete forms, make payments, stay in touch, confirm your visits, and customize your reminders.
For your convenience, your new patient paperwork can be accessed online and completed right on the screen. Simply follow the personalized link you received by text or email, complete the forms on the screen and submit. You can also access your forms from the Modento Mobile App mentioned above! If you can’t find your links, or have any other difficulty completing these online forms, please call our office and a SLO Smiles staff member will be happy to assist you.
New Patients
Complete New Patient Forms are important to the success of your first visit and are required before your appointment day. Please complete them as soon as possible by following the personalized links we sent you. If you prefer hardcopy, you can download and print the packet below and send them to us by mail. If we have not received your patient forms ahead of time, your appointment may be rescheduled.
If you have any questions prior to your first visit, please visit our New Patient FAQ page, or
Optional Forms:
Insurance Information: As a new patient, if you have dental insurance, you must complete this form. If you have had a change of insurance, you can use this form as well! All insurance information must be in place ahead of your new patient visit to be used that day. Please call the office if you need assistance!
Authorization to Release Records: Give us permission to send your records to you, another dental office, or gives another dental office permission to send your records to us. It also gives us permission to talk to another person about your care here. This is required for adult children when parents want to be involved in care and accounting.
Patient Documents
Notice of Privacy Practices
Direct and Indirect Restorative Materials
Medication List