Center for Oral & Facial Surgery
Oral and Maxillofacial Surgery
San Diego
619.299.3320
  • HOME
  • PATIENT INFORMATION
    • Introduction
    • First Visit
    • Scheduling
    • Financial Policy
    • Insurance
    • Privacy Policy
    • Oral Surgery Videos
  • PROCEDURES
    • Dental Implants
    • Bone Grafting
    • Wisdom Teeth
    • Impacted Canines
    • Facial Trauma
    • Jaw Surgery
    • Oral Pathology
    • Sleep Apnea
    • Platelet Rich Plasma
    • Obagi Blue Peel
    • Rhinoplasty
    • Browlift
    • Eyelid Surgery
    • BOTOX® Cosmetic
    • Facial Liposuction
  • MEET US
    • Meet Dr. William E. Hendrix
    • Meet Dr. Frank L. Pavel
    • Meet Dr. James R. Eckstein
    • Meet Dr. Brian K. Oleksy
    • Meet the Staff
    • Office Tour
  • SURGICALINSTRUCTIONS
    • Before Anesthesia
    • After Implants
    • After Wisdom Teeth
    • After Exposure
    • After Extractions
    • After Multiple Extractions
  • REFERRING DOCTORS
    • Referral Form
    • Study Club
    • Links of Interest
  • CONTACT US
    • Contact Information
    • San Diego Office Map
    • El Cajon Office Map

Online Forms

  • Patient Registration

Online Patient Registration

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

Technical Note:

PC Users
Our online form uses the latest version of Adobe Acrobat Reader to conveniently submit the form from home or work. Please download the free plug-in from Adobe’s web site if it is not already installed on your system. It is important that you have at least version 9 of the plug-in to successfully use our online form.

Mac Users
You must open and submit the form in a Safari Browser with the latest Mac operating system. It is also important to have the latest version of Adobe Acrobat Reader on your computer in order to submit your form to our office correctly, please download the free plug-in from Adobe’s web site.

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