New Patient Forms

The attached files contain our new patient forms that will need to be filled out when you arrive at our office. Printing them, filling them out, emailing them, or bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

Patient Forms (Print & Complete All Forms Prior To First Office Visit)

Medical History

Business Policy

Patient Registration

HIPAA Policy

Happy Smiles :)

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"OMG! I am so happy I found Harbor City Dental and Dr. Camille! It is quite evident that their main mission is quality work and excellent customer service! Each and every person in this practice is awesome! They treat everyone in such a kind way! "
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“Best dentist in the area! One of the few that still has nitrous on the menu. Which is great for a nervous patient like me. Dr. Burnes is awesome and takes his time with you to make sure you understand everything. I cannot recommend Harbor City Dental enough!”
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Dr. Burnes is wonderful and his staff is amazing. Hardly have to wait, everyone is friendly, and you know they aren’t trying to take advantage of you. Highly recommend!
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“From the front desk to my dental hygienist and dentist, the environment and friendly demeanor of everyone at Harbor City Dental makes any dental procedure less stressful! I truly appreciate my treatment plan and estimated out of pocket expense printout when I leave. They understand me and my teeth. The dentist is no longer my least favorite place to visit.”