Are you planning your first visit to City Dental Centers? When you arrive at our office, you will probably have quite a bit on your mind, especially if you are bringing your children in to see our dentists. To make your visit easier and give you more time with Dr. Sam and associates, you can fill out your patient forms before your dental appointment in West Covina, California. You can download and complete your forms and bring them with you to our office, or you can securely submit your paperwork online. If you need assistance, please do not hesitate to call our office at 626-962-1722.

Downloadable Forms

Consent Form (English)
Consent Form (Spanish)
Health Information Form (English)
Health Information Form (Spanish)

Online Forms

Consent Form
Health Information Form