Nicole E Pagonis DDS
Dentistry in Los Gatos, CA

New Patient Forms

Save time waiting in our office by filling out necessary forms online. Feel free to give us a call if you have any questions.

COVID-19 PANDEMIC - PATIENT DISCLOSURES

 Please print and email completed form to contact@doctorpdentistry.comPaper copies will not be accepted. 

New Patient Packet

Includes NP information, Med Hx, HIPAA, FIN. Policy, Dental Materials Fact Sheet, and Local Anesthetic Consent.

Release of Information

Change to Dental Insurance

Payment Information

Have Questions? Get in Touch
If you have difficulty using our website, please email us or call us at (408) 399-3920
View the ADA Accessibility Statement
Email: contact@doctorpdentistry.com

AFTER JUNE 15th, 2021 PLEASE STILL EXPECT THE FOLLOWING: CURBSIDE CHECK-IN

JUST PRIOR TO ARRIVAL: You will receive a text message. Please respond after you have parked and remain in your car.  You will be instructed when to proceed to our office entrance. This will occur when your room is available. 

UPON ARRIVAL TO ENTRANCE: REMAIN SIX FEET APART, WEAR A MASK, WE WILL COME OUT TO GREET YOU or WAVE YOU IN!  *Text or Call the office if you are not greeted promptly. 

Please click HERE to refer to our Covid-19 page for details and UPDATES. As healthcare providers we are committed to providing you dentistry in a clean and safe way.