Patients who are new to Yountville Dental will be required to complete the Patient Information, the Dental Health History and the Health History forms before their initial visit. For your convenience and to save time, we have provided links to these forms below.


Our forms are in Adobe® PDF format. If you have trouble opening these forms, you can download and install a free copy of Adobe® PDF Reader at

Dental Health History Form

      Details                    Download

Patient Information Form

      Details                    Download

Health History Form

      Details                    Download