Patient Forms

Thank you for choosing our Dental Office. If you are a new patient to our office, the following link contains our new patient bundle with forms that will need to be filled out when you arrive at our dental office. Filling them out now will allow us to attend to your dental needs more quickly than completing them on your arrival. The second link is for existing patients to login and view/update their account information. If you have questions or would like more information please call our Beverly Hills dental office at 310-657-9373.


Link takes you to a secure site to protect the privacy of your personal information.

Printable Patient Forms

For your convenience, we have also made our most common forms available to you online in printable PDF format. If you do not wish to use the above links to complete your new patient forms online please click on the links below to print and fill out the forms by hand prior to your first appointment. The first form is our patient Welcome Letter. Please print out the one that corresponds to the office you will be visiting. Most of the information in these letters is available on this Web Site, but we always like our new patients to have a printed copy.

The next two documents are our Health History Form, and our HIIPA Forms. Please print both these forms, fill them out, and bring them with you to your appointment.

 If you have any questions, or need help with any of these forms, please don’t hesitate to contact us. 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

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Gary Blankstein, DDS
Cosmetic & Implant Dentistry

Beverly Hills Dentist Dr. Gary Blankstein dental professional dedicated to General, Family & Cosmetic Dentistry with services including Dental Exams, Dental Makeovers, Teeth Whitening, Veneers, Crowns, X-rays, Fluoride, Cleanings, & more. Please come and visit Beverly Hills, CA dentist Dr. Gary Blankstein.

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