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Patient Resources

healthier smiles for healthier lives

New Patients Welcome

Thank you for choosing Dr. Siamak Najafi, Dr. Don Jayne, and our team of established dental care experts, as your partners for excellent health and continued well-being.

Every visit to our office begins with a conversation about you. We want to know about:

Open communication is welcome in our office. If there is anything we can do to make dental visits more comfortable please share your thoughts with us.

Making Dental Health Easier

As experts in dentistry, we’re here to help you stay healthier, longer.

Our experts offer tips to improve your dental health during office visits and through care at home.

After all, your teeth should last a lifetime.

Patient Forms

Please download the PDF to fill out your form or click the link below to access the online forms for your convenience.

Prosthodontic
Referal Form

Medical Clearance Form

Release of Records

Dental History

Please complete the dental health history form. The information you provide informs Dr. Najafi and Dr. Jayne to properly approach your dental care.

Medical History

Please complete the medical health history form. The information you provide informs Dr. Najafi and Dr. Jayne to properly approach your dental care.

Patient Registration

We honor your right to privacy. This form explains how we handle HIPAA and Protected Health Information records in our dental practice.

Financial Policy

HIPAA Acknowledgement

Use the buttons below to download the forms. the forms below are for Acknowledgement of Privacy Practices and Notice of Privacy Practices.