Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

*Please note, due to recent updates in the Google Chrome Browser, it is no longer supported by the following forms. Please use an alternate browser to complete you patient registration.

Online Registration Form button

Our offices are located at:
9 E. Pedregosa, Santa Barbara, CA.
122 S. Patterson, Bldg A, STE. 111, Santa Barbara, CA.

Please call with any questions or to schedule a consultation with one of our Oral Surgeons!