Patient Forms and Instructions
Would you like to save some time during your appointment with Dr. Rakhi Jani? We welcome you to complete our new patient paperwork before your first visit with our dentist in Livermore, California. By completing these forms in advance, you can help to make certain that your experience at our office is as streamlined as possible. If you need assistance or if you have any questions, please do not hesitate to call or visit us today at Smiles Unlimited. We are happy to help!

New Patients Forms

Patient Information form

Health History form

Dental Health History form

Financial Policy

HIPPA Disclosure Agreement

General Consent form

Notice of Privacy Practices

Patient Instruction Sheets

 Instructions after Extraction

Instructions after Denture

Instructions after Arestin