New Patient Form


New Patient Forms and Online Forms

Plaza Dental Group offers our new patient form online so it can be completed it in the convenience of your own home or office. Follow these easy steps:

  • Download the necessary form, print it out, and fill in the required information.
  • Bring them with you to your appointment.

This lets us know the history and current state of your dental health. What questions, concerns, goals, regarding dental care can we help you with? Let us know!


Click to download New Patient Form (English) - Required


Click to download New Patient Form (Spanish) - Required


What we offer


Plaza Dental Group
3390 Loma Vista Rd, Suite A
Ventura, CA 93003
Phone: 805-270-2651
Fax: 805 658 6459
Office Hours

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