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Dental Patient Forms

We’ll need the information on the forms below prior to getting started. Please download the form, complete it and bring it to your first visit. If you are not able to complete these forms prior to your first visit, please arrive 10 minutes before your scheduled appointment.

The forms are PDFs and require you have Adobe Reader to open them. (Nearly all computers have this. If you cannot open the form, you can download it here: Adobe Reader.)

Patient Information

Patient Form

Medical History

Medical Form

Dental History

Dental Form

Insurance Information

Insurance Form
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Restorative, Cosmetic, and
Implant Dentistry

Laurie T. Hanschu DDS
6660 Coyle Ave. #240 
Carmichael, CA 95608

Phone: (916) 966-5269

Office Hours:
Mon: 8:30am - 5:00pm
Tue: 8:30am - 5:00pm
Wed: 8:30am - 5:00pm
Thu: 8:30am - 5:00pm
Fri: 8:30am - 5:00pm
Sat-Sun: Closed
Schedule Your Appointment

Dental services

HomePreventative CareCosmetic DentistryDental ImplantsComplete Dentures
Partial DenturesSedation DentistryDental BridgeNight GuardsDental CrownsLaser Tissue RecontouringMini Dental Implants

DENTAL SPECIALS

Dental Implants SpecialSmile Makeover SpecialNew Patient SpecialFree Implant Consultation

GENERAL information

Patient FormsPatient ReviewsSmile Gallery

About us

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