Achieving the smile of your dreams starts here.

To schedule your dental appointment with Smiles on Clark, begin by filling out the New Patient forms.

Filling out these forms is required before we can schedule your appointment, or provide you with any dental services or quotes. It also enables us to serve you more efficiently once you’re in our office.

Thank you for choosing Smiles on Clark. We look forward to serving you!

Option 1

Fill out the forms online.

  • All your information is entered, submitted, transferred and stored securely, responsibly and lawfully.

Option 2

Download & print the forms.

  • Return completed forms to our office in Orcutt at 1108 E. Clark Ave, Ste 160, or by fax to (805) 937-0762.