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Dentist Costa Mesa
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New Patient Forms

General Dentistry Costa Mesa, Newport Beach
For your convenience, our New Patient Forms are available to be filled online with a secure service which will ensure the privacy and security of your medical and personal information. Please fill out these forms at home before your first appointment. They will be available at the reception when you come for the appointment. If you need assistance with filling, please contact our office.

» New Patient Registration & Health History form (Adults)
» Pediatric Health & Registration form
What's New
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Dr. Do was featured on the CBS TV Show "The Doctors", performing a Laser Dental procedure on stage!
Testimonials
"Dr. Rolfes and his staff are fantastic. I was referred to them from a friend and it's been the best dental decision I've made. They keep me consistently well-informed and make me feel comfortable; even through my unnerving dental procedures.

You can't go wrong going to their offices."
Kayleen K.
Laguna Niguel, CA
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