Patient Forms

Our New Patient Forms

Appointment

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone at 510-243-0213 or email info@daliaperezsalinasdds.com

Patient Forms

If you are a new patient to our office, please download our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please contact our office if you have any questions at all.


Download our four forms below. Please print, fill-out, and bring with you to your appointment.

Dental Forms — Pinole, CA — Dalia E. Perez-Salinas, D.D.S.

Dental Insurance

Affordable Full Coverage Plans

Dental For Everyone

Our patients without dental insurance often inquire if there are options for them to purchase a dental plan privately. Visit the website above and type in your zip code for an instant quote on affordable dental plans. We are a Delta Dental Premiere office. We recommend the Dental for everyone Immediate coverage Plan for maximum benefits and no waiting periods (with the exception of orthodontic treatment).

Payment Options

For your convenience, we accept cash, care credit, most major credit cards and many other forms of payment. Payment is expected at the time services are performed. Feel free to contact our office If your treatment plan requires more comprehensive dental work and you want to discuss financial options.

CareCredit
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