Fullerton Dental Care
Asal Shirazi, DMD
Family and Cosmetic Dentistry
Call: (714) 870-2000

Patient Forms

Fullerton Dental Care is pleased to welcome new patients! If you are new to our practice, we recommend reviewing and completing your patient forms prior to your first appointment. This means that we can complete your paperwork faster and allow you to have more time visiting with our dentists in Brea, California. We want to make your dental care convenient and easy. If you have questions about our patient forms, or if you are ready to schedule your first appointment with Dr. Shirazi, please call us today at (714) 617-2694. We look forward to caring for your smile!

NEW HEALTH HISTORY 2016

NEW HEALTH HISTORY (SPANISH)

SPANISH HIPPA

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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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Office Location

  • Brea
  • 747 S. Brea Blvd Suite 34
  • Brea, Ca
  • 92821
  • Map & Directions
  • Call: (714) 870-2000
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