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 MARCH 1ST, 2022 

Please proceed to the office after you have parked. 
Please wear a mask and wait outside, we will promptly waive you in when ready.
If you are NOT greeted within five minutes: please enter, hand sanitize and be seated in the waiting room. 
Please inform our front desk you are here for your appointment. 

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.