Jaime A. Vergara, DDS, PA

Periodontal Practice with Emphasis on Dental Implants

Good care is our strength !

Forms and instructions

For your convenience, we have provided printable new patient forms and surgical forms. The new patient forms may be brought with you on your first visit or the day of the surgery.

Referring Doctors Form:

Referral Form

New Patient Forms:

Welcome Form and Policies

Personal information

Medical History

Office Directions

Surgical Forms:

Dental Implants

Bone graft

Extractions

Oral sedation

New Bisphosphonate form

Surgical instructions:

Pre surgical instructions

Post surgical instructions