Patient Forms

You may access the following forms to assist us with your care. Please complete the following forms, and click the "Submit" button at the bottom of each form.

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

Placerville Dental Care

  • Placerville Dental Care - 941 Spring St #6, Placerville, CA 95667 Phone: (530) 622-9412

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