18800 Main Street, Suite #201
Huntington Beach, CA 92648
Periodontics
& Implant Dentistry
Peter A. Russo, DDS, Inc.

Patient Forms

Please submit or print out these forms prior to your first visit.

Patient Forms

To continue making your dental experience a pleasant one, we have conveniently provided our dental forms below so that you can fill them out securely online in the comfort of your home, or you may print them off and bring them to your next appointment. Please fill out the forms completely and to the best of your knowledge.
*If you are printing the forms please make sure all check boxes are visible, feel free to call the office for any assistance or questions with our forms.

Welcome Message

Patient Information
General Health and Insurance

COVID-19 Pre Screening Consent Form
Please fill out no more than 4 days prior to your appointment date

COVID-19 Office Screening Consent Form
Please fill out on the day of your appointment

Notice of Privacy Practices
About PHI and Patient Privacy Rights