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New Patient Forms


Assistant  showing patient online forms on a digital tabletYou may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. Contact us if you have any questions or would like to schedule a visit.

Online Registration Form



Office Hours



Monday
Tuesday
Wednesday
Thursday
Friday
7:45am-4:30pm
7:45am-4:30pm
8:00am-4:00pm
7:45am-4:30pm
6:45am-2:00pm

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Placentia Oral Surgery • New Patient Forms
The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. Contact us if you have any questions.
Young Jun DDS MD FACS, 601 E. Yorba Linda Blvd. #9, Placentia, CA 92870 • (657) 216-1617 • placentiaoralsurgery.com • 3/27/2024 • Associated Words: oral surgeon Placentia CA •