Dental Patient Forms for Your Visit in Orange, CA
Starting your care at Glassell Dental should feel easy — and that begins before you even walk through the door. Completing your forms in advance means less time at the front desk and more time focused on you. We welcome new patients and are proud to accept PPO insurance from many of the leading carriers, so getting started is straightforward. Our team is ready to answer any questions you have before your appointment.
Complete Your Dental Intake Forms Before You Arrive
Taking a few minutes to fill out your intake forms Orange CA patients need before a first visit helps everything run smoothly. When our team has your health history and insurance details ahead of your appointment, they can prepare a thorough, personalized experience from the start. We believe your time matters, and this is one of the ways we show it.
New Patient Forms Packet
Secure, HIPAA-Compliant
Complete health history, dental history, and insurance authorization forms all in one streamlined packet.
- Complete Health History
- Dental History Questionnaire
- Insurance & Consent Policies
Returning Patient Update
Quick Update
Update any changes to your address, phone number, health history, or dental insurance coverage.
- Changes in Health Status
- New Insurance Provider / Group
- Updated Contact Details
New Patient vs. Returning Patient Forms
New patients will need to complete a full health history form, a dental history questionnaire, and an insurance authorization. Returning patients generally only need to update any changes to their health history or insurance coverage. If it has been more than two years since your last visit, our team may ask you to complete a refreshed health history to make sure your care plan reflects your current needs. Not sure which forms apply to you? Contact us and we will point you in the right direction.
What to Bring to Your First Appointment
Even after completing your forms, please bring the following to your visit:
- A valid photo ID
- Your dental insurance card
- A list of any current medications or supplements
- Any relevant dental records or X-rays from a previous provider, if available
What to Expect at Glassell Dental in Orange, CA
From the moment you arrive, our goal is for you to feel at ease. Dr. Sherry Darabi and Dr. Marilyn Nguyen lead a team that takes time to listen, explain every step of your care, and make sure you feel like a true partner in your treatment — never just a name on a schedule. Our office is conveniently located in Old Towne Orange and is easy to reach from the surrounding area.
Your Dedicated Doctors
Upholding Old Towne Orange's highest clinical and hospitality standards.
Insurance & Payment Information
We accept a wide range of PPO insurance plans, including Aetna, Cigna, Delta Dental, MetLife, and UnitedHealthcare. Financing options are also available through CareCredit, Cherry, and Sunbit for patients who prefer a flexible payment plan. For a full breakdown of accepted plans and financing details, visit our Insurance & Financing page.
Frequently Asked Questions About Our Patient Forms
Have more questions about the forms process? You will find additional answers on our FAQs page, but here are the most common ones we hear.
Ready to get started? Reach out to our team and we will take care of everything from here.
Still Have Questions? We're Here to Help
Our team at Glassell Dental is always happy to answer your questions — before you even walk through the door. If you do not see your question listed here, reach out and a member of our warm, knowledgeable team will get back to you quickly.