New Patient Forms for Oral Surgery

Online Patient Registration

You may pre-register with our office by filling out our secure online Patient Registration forms. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. After you submit your forms, you will have the opportunity to securely upload and transmit images of your insurance card.

Please call our office if you have any questions or have not yet scheduled your consultation appointment: Palo Alto Oral & Maxillofacial Surgery Office Phone Number 650-617-1900.

Patient Registration Form

We ask that patients with non-Delta insurances fill out the form below, with their complete insurance information, since this will be required for claim submission. While we can attempt to submit claims with partial information, insurances are likely to discard them as incomplete rather than processing them.

Out-of-Network Verification Form

Office Hours

Monday through Friday:   8:00 AM - 5:00 PM