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Patient Forms

We are a, "Green Office", paperless office so we highly encourage everyone to fill out the online forms.

 

If you already have an appointment, please complete this secure online form to save time and paper: Secure Online Form

SECURE ONLINE FORM REQUIREMENTS: Safari web browsers are NOT supported. You must use Internet Explorer 7 or higer web browser. If you need to upgrade your web browser then click on the icon below to download the Free updated web browser.

DOWNLOAD INTERNET EXPLORER

 

 

All information collected is directly transmitted to a secure email account and is not kept on a public web server. Information is used solely for appointment scheduling and patient contact and is not shared or sold under any circumstances. If you have any concern regarding the confidentiality of your information, please call our office directly or email us at info@littlesmilesoc.com

©2009 Little Smiles of Orange County | Woodbridge Square Medical Bldg., 4980 Barranca Pkwy, Suite 101, Irvine, CA 92604
Phone: (949) 733-3433  Fax: (949) 733-3437