patient information

| Consultation |

Registration Desk, Periodontics & Implant Dentistry San Diego CAPlease assist us at the time of your initial visit to the office by providing the following information:

  • Your referral slip and x-rays from your referring dentist.

  • A list of medications you are currently taking (please note that you can fill out your patient registration and medical history form on this web page.)

  • If you have dental insurance, please bring any forms or insurance cards with you to the appointment.


*Please Note: All patients under 18 must be accompanied by a parent or guardian at the consultation appointment.

Please notify the office if you have a medical condition or concern prior to surgery (e.g. artificial heart valves or joints, heart murmurs requiring premedication, severe diabetes, or hypertension.)

If your referring dentist has taken x-rays, you may request that they be forwarded to us.



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Roya Niakiani, D.M.D. | Periodontist | 6th Avenue Periodontics & Implant Dentistry
1111 Sixth Avenue, Suite 102 San Diego, CA 92101 | T 619.702.7113

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