Wrightwood Dentistry

Seung K. Shon D. D. S.



Please download and complete the five forms below and then bring with you to your first appointment.
Click on single images below, then use "Control + P" to send form image to your printer
or save as an .xps file to your desktop to print later.

Patient Information (Confidential) - page 1 of 5

Patient Information (Confidential) - page 2 of 5

Medical History Continued - page 3 of 5

Consent for Use and Disclosure of Health Information - page 4 of 5

General Dentistry Informed Consent - page 5 of 5

We guarantee your privacy.

Your personal information is kept strictly confidential

Call today for an appointment

Wrightwood Dentistry
P. O. Box 3159,
1329 State Highway 2, Suite C
 Wrightwood, CA 92397
Office and message: 760.249.5411
Emergency only:  310.923.3902
Email:  wrightwooddentistry@gmail.com
Website Builder