Rudolph Dean Lang, D.D.S., apc. - Payam Samouhi, D.D.S., M.D., apc. - Don Kim D.D.S., M.D., apc.
Forms
Patient Forms for your convenience.

Click To Download PDF Files Below:

Please print applications:

First Office Visit Forms-
Download and fill out to save time on your first visit to our offices!

Download Health History Form

Download Appointment Surgery Form


Post OP Surgery-
Download for your usage for procedures.

Download PO Bone Grafting

Download PO Dental Implants

Download PO Exposed and Bond

Download PO Impacted Teeth

Download PO Sinus Floor Grafting

Download PO Surgical Biopsy


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Something To Smile About



♦ Tranquil and Friendly environment
♦  State of the Art facility utilizing the latest technology
♦  Digital x-ray imaging
♦ Convenient in office 3-D Volumetric dental CT scan
♦ Oral/Facial reconstruction using the most innovative bone grafting and implant techniques
♦ Atraumatic wisdom tooth removal
♦ Courtesy insurance billing / financing
♦ In office Intravenous sedation / general anesthesia

Our staff

At all of our locations, your overall happiness and safety is our number one priority. We will work with your general   dentist as well as other dental  specialists involved in your care to help you reach optimal results.
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