Southern California Endodontics

Patient Forms

Please print out the forms below and bring them, filled out, to your appointment. This will help you save time at your initial visit. 

Consent Form

Medical Dental History Form

Patient Information Form

• "Dr. Soleimani was very nice and professional. She cares about my comfort and she explained and gave heads up on what she did during the root canal procedure."
  -Peggy T.
• "The doctor taking time to investigate and communicate what was best for me, this was professional and done in a pleasant way. Everyone did a great job, a good team"
  -D.L.R.