Appointments

Before we can begin your treatment at Phan Orthodontics, we will need some basic information about you, your orthodontic needs, your oral health, and your dental and medical history. To streamline your appointment at our office, we invite you to complete our new patient forms before your visit with Dr. Derick Phan, our orthodontist in San Jose and Almaden Valley, California. If you have any questions or need assistance of any kind, we encourage you to contact our office. Our team is happy to help!

Child Health History (English)
Adult Health History (English)
Notice of Privacy Practices (English)
Acknowledgement of Receipt of Privacy Practices (English)
Automatic Credit Card Authorization

Child Health History (Spanish)
Notice of Privacy Practices (Spanish)
Acknowledgement of Receipt of Privacy Practices (Spanish)