Please help us be prepared for your first appointment by completing this Patient Information, Patient Health History, Office Policy, and HIPAA Acknowldgement form. 

Download the forms below (in PDF format) to your computer, print it out, complete forms, and bring with you to your first appointment.

HIPAA privacy policy available upon request.

If you are unable to read PDF files, you can download Acrobat Reader free from Adobe.

Contact Us

Beverly Claiborne, DDS

(510) 792-8765
39572 Stevenson Place Suite 127Fremont, CA 94539