Printable Patient Forms

Please print and fill out the following forms and bring with you to your next appointment with Dr. Eng. This will help ensure a smooth check-in experience and allow us to serve you best! If you have questions while filling out the forms, please call us at (714) 779-2736.

Patient Information Form
Responsible Party Form
Primary Insurance Form
Secondary Insurance Form
Consent For Services Form
Medical and Dental History Form

Please note that you will need Adobe Acrobat Reader to download and open these forms. You can download this program for free click here.

Please contact our office at (714) 779-2736 for the username and password to fill out the appropriate forms.

The online forms link is https://kiosk.ident.com

East Lake Advancing Dentistry
20397 Yorba Linda Blvd
Yorba Linda, CA 92886

(714) 779-2736