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Patient Registration

San Jose, CA Patient Registration | Galan Dental 

We offer same day Emergency and Saturday appointments for your convenience. You 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.

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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 are one of our primary concerns and we have taken every precaution to protect it.

Please assist us in expediting your visit by providing the following information at the time of your consultation or first visit:

  • Any x-rays taken by a previous dentist, if applicable within the last year.
  • A list of medications you are currently taking and notifying us of any premedications needed prior to your appointment-please check with your physician if you are not sure.
  • Dental insurance card and/or your spouses.
  • Filling out our medical and dental history online prior to your arrival.

 

Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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