Ron Conway Family Gateway Medical Building
1825 4th Street, 5th Floor
San Francisco, CA 94143-4072
Phone: (415) 476-4146
Fax: (415) 476-4209
Faculty practice and Hospital Dentistry
New patient Forms
Please download, print, and complete the enclosed registration forms, including Terms and Conditions of Treatment form, New Patient Form (NPE) and Medical History Form (Available in English or Spanish), prior to arriving to your appointment.
Please arrive 15 minutes prior to your appointment with the completed registration forms in hand. If you are unable to keep the appointment, we request that you contact us at least 24 hours prior to your appointment at (415) 476-3276. The optional Doctor Excuse Form for the school is available as needed.