WU Dental, 1919 O’Farrell Street, Suite 1, San Mateo, CA 94403 • (650) 571-6666 • (650) 358-9999 FAX •firstname.lastname@example.org
Thank you for your trust and welcome to Dr. Wu’s office.
When you arrive for your first visit, please complete some forms that will allow
us to begin your dental treatment. These forms are also listed below. You may print
and fill out the forms, and bring in them for your first visit at our office.
Your initial visit will last approximately one hour, which normally includes a comprehensive
review of your medical and dental history, oral cancer screening, intraoral and extraoral
exams, periodontal charting (gum exam and measurements), digital x-rays, digital
photos, smile analysis, and a detailed report that outlines your current dental conditions
and possible treatment plans in the future. In most cases, we will also clean your
teeth and provide you with oral hygiene instructions to help you care for your teeth
It is our mission to provide you with high-quality and affordable treatment that
fits your budget. We offer a variety of payment options to meet your needs. Please
ask us about financing options, credit card payments and bank drafts. We thoroughly
explain your options, so that we can accommodate your needs.
Listed below are the forms that you can print and fill out prior to your visit. To print the forms you will need Adobe Acrobat Reader. If you do not have it, please click Adobe Acrobat Reader to download it for free to your computer. Thank you.