UP Forms & Documents

Professional Gum Disease Treatment San Jose, CA

The office was designed for you; our patients. With any procedures, we make sure to give you all prescription medications, along with our pre-op and post-op instructions.

All forms are located here for you to download. This makes for a better patient experience both pre- and post-operatively. Feel free to contact us if you have any questions. We always look forward to having you in our office.

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UP Post Op Extraction Form
   Instuctions for care of the mouth following tooth
Post Op - Lanap Diet UP Post Op Lanap
   Post LANAP Diet Instructions following Laser Therapy.
Post OP - Gum Grafting Information UP Post Op Gum Grafting
   Instuctions for care of the mouth following Gum
   Grafting procedures.
Post Op - Perio Surgery UP Post Op Perio
   Instuctions following Periodontal surgery.
Post Op - Implants Info UP Post Op Implants
   Instuctions for patients receiving implants.
Pre-Surgical Instructions Pre Surgical Instructions
   Patient instructions prior to surgery.
HIPPA Notice Hippa Notice    This notice describes the privacy practices of our office
   and how your health information maybe used or
UP Patient Medical History Medical History
   Patient information regarding health, allergies,
   and medical conditions.
UP Financial Policy UP Finance Policy
   Payment information including fees, terms, and plans.
Patient Registration Form

Patient Registration Form
   Patient personal and insurance information.

OSS Consent Oss Consent
   Consent to the performance of oral surgery.
IV Sedation Consent Form

IV Sedation Consent Form
   Intravenous conscious sedation informed consent.

IV Instructions IV Instructions
   The DO's and DONT's after anesthesia and sedation.