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To save time, you may print our patient information form, complete it before your appointment, and bring it with you. Or you may fax it to our office at 510-657-8964.

This form is in Adobe's Portable Document Format (PDF). If you do not have the Adobe Acrobat Reader installed on your system, you may download it for free from Adobe's website.

 

 

 

 
 
 


© Rick Marlais, D.D.S. 2003-2006

510-657-4168
43341 Mission Blvd., Fremont, CA 94539



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