Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

New Patient Forms (Print & Complete All Forms Prior To First Office Visit)

New Patient Information

Existing Patient (Print & Complete Prior To Your Appointment)

Release of Dental Records 


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Connect With Us

contact-img

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Ready to come in for an appointment?
Contact us today!

Gerald M. Schneider, DDS Nathan A. Loeffler, DDS
General & Family Dentistry
Creating Beautiful Smiles for all Ages

Visalia dentist, Dr. Gerald M. Schneider is a dental professional dedicated to general, family, and cosmetic dentistry with services including dental exams, dental makeovers, teeth whitening, veneers, crowns, x-rays, cleanings, and more. Please call our dentist in Visalia, CA to schedule your next appointment.


Site Developed by Prosites.com