Patient Forms
Patient Forms
Patient Dental Forms

To continue making your dental experience pleasant, we have conveniently provided our Patient History Form below.

Feel free to fill this form out in the comfort of your home, and bring it into the office with you.


Patient History Form

  • ★★★★★
    To Dr. Lee and all his front and back office staff,

    I went to your office at 8AM on Monday the 15th. I needed help for an irritating toothache. Even though I was a first time patient, you took me in immediately. I was treated with concern and kindness by everyone. You solved my problem and I appreciate it. Thank you for everything.
    - Bill W.
    12/31/1969
    Click here to see more patient reviews
Get The Care You Deserve!

Rancho Cucamonga Dental Care would love to meet you and your family. Our office provides the dental care you need to achieve the beautiful, natural look you seek. We can even reshape your natural teeth to make them straighter and more youthful. Our office is easily accessible and makes it convenient to those living near Rancho Cucamonga to get the care they deserve.

Request An Appointment Online

Or call us today at: (909) 989-7888