New Patient Forms

Call (805) 322-8653

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.

We also recommend reviewing the New Patient Exam and Brushing & Flossing videos here prior to your appointment. These videos will provide a good general overview of what to expect during a new patient exam which may include x-rays to determine the appropriate course of action for prophylaxis (or teeth cleaning) as well as recommendations to augment your current dental hygiene schedule.

Thank you for your interest in Potts Dental.

Patient Forms  (Print & Complete All Forms Prior To First Office Visit)

HIPAA Policy

Cancellation Policy


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 If you do not yet have your appointment scheduled and whether you are in need of a complete exam and cleaning, a full-mouth restoration, or anything in between, we promise to provide you with exceptional care as we enhance the natural beauty of your smile. We welcome you to complete our online form here or contact our office directly at 805.388.3319 and we will be happy to help answer any questions or concerns you may have.

When you need a dentist in Camarillo, CA - look for professionals willing to provide care that's more than just gentle on your teeth. In order to ease your anxiety and get you the care you need for a healthy, radiant smile, our Potts Dental location on Rosewood Ave provides comprehensive service designed to provide you peace of mind.

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We combine experience with the latest in dental technology to deliver the best patient experience possible.

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