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(661) 387-6577

3409 Calloway Dr., Suite 402 Bakersfield, CA 93312

info@customdental.com

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Our forms are available for download for your convenience.

Patient Information Form

Health History Form

Financial Policy v1-4

Dental Materials Fact Sheet

Notice of Privacy Practices

Minor Consent Form Link to:

*Our dental operatory chairs have a maximum weight capacity of 350 lbs. If your weight exceeds this, please contact us so that we may refer you to an office we are working with that is properly equipped to suit your needs.*

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(661) 387-6577

3409 Calloway Dr., Suite 402
Bakersfield, CA 93312

info@customdental.com

Tuesday-Saturday 8am to 5pm,
Sun-Mon Closed

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