William C. Jaques, D.D.S. - 6805 Quail Hill Parkway, Irvine, CA 92603 drjaques@wcjaquesdds.com

Patient Forms

What to expect

Being well prepared for your appointment will ensure that Dr. Jaques will have all the necessary information to be able to provide you with the best possible dental care and service. It is important that we obtain a patient/health history which would include you to provide a list of any medications that may interfere with your treatment.  Please bring forms in with you to your appointment.  See "patient forms" below.

In order to get acquainted with you, our dental assistant will inquire about your previous dental history.  She'll then take full mouth digital radiographs.

Dr. Jaques will then review with you your past dental history and learn what your current dental needs are.  He will examine your teeth and mouth by using the digital x-rays and explain to you the conditions present.  At this time he will answer any questions you may have.  Depending if there is complexity in your case, an additional consultation may be necessary.

You will then be assisted to our highly-skilled dental hygienist who will perform an oral cancer screening and a periodontal screening, which measures for bone loss.  Your visit will include a cleaning of your teeth and gum tissue.  She will explain the condition of your gums/tissue and give you personal oral hygiene instructions for what your needs are.   Additional cleaning visit's may be necessary.

Upon completing this visit, we will appoint you according to your particular dental needs.



Patient Forms
Please print and fill out these forms so we can expedite your first visit:


In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.



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