Patient Registration

RANDALL R. GORDON, DDS, MS

 

PERIODONTICS &

DENTAL IMPLANTS

 

1420 South Mills Avenue, Suite G, Lodi, CA 95242

Phone: 209.367.1484  Fax:  209.366.0998

 

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Randall R. Gordon, DDS, MS  - Practice Limited to Periodontics and Dental Implants

1420 S. Mills Ave., Ste. G, Lodi, CA 95242 • Phone: (209) 367-1484 • Fax: (209) 366-0998

Copyright  ©  2013 gordonperioimplants.com  • Email: info@gordonperioimplants.com

Proudly serving the Stockton,

                Lodi & surrounding areas.

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Patient Registration

You are encouraged to print out the following new patient forms and fill them out prior to your first appointment with Dr. Gordon.   It will save you time if you fill out the Patient Information and Medical History form at home before your first visit with us. You may mail them or fax them to our office at (209) 366-0998.

 

Patient Information Form

 

Medical History Form

 

 

These are PDF files and you must have Acrobat Reader installed on your computer to view them. If you do not have Acrobat Reader please click here to download a free copy.

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