Millbrae Dental Care
Dental Implants, Sleep Apnea, TMJ Pain Relief and Cosmetic Dentist

Downloadable Forms For You, Our Patient


Below are forms you may need for your visit. If you have any questions, please call us or email us:

(650)-583-5880

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New Patient Information Form - Adult    |   Fill out online

Office Policies & HIPPA Form    |   Fill out online

» New Patient Information Form - Child   |   Fill out online

» New Patient Welcome Package - Meet Dr. Tsai and her team

» X-Ray & Medical Release - send to your previous Dentist    |   Fill out online



Sleep Apnea Related Forms


New Patient Information Form - Adult    |   Fill out online

Office Policies & HIPPA Form    |   Fill out online

Epworth Sleepiness Scale ESS Form

CPAP Intolerance Affidavit    |   Fill out online

Clinical Limitations of Oral Appliance Therapy    |   Fill out online

Oral Appliance Therapy Consent Form    |   Fill out online

» Sleep Apnea Self Evaluation

» Oral Appliance Referral & Medical Necessity Form

» Somnomed Warranty Card

» Somnomed Adjustment Instructions




TMJ / TMD Related Forms


» TMJ/TMD Referral & Medical Necessity Form




If there are any other forms or information we can provide, please send us an email or give us a call:

(650)-583-5880




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New Dental Patient and Medical Sleep Apnea & TMJ Patient Forms at Millbrae Dental Care