Online Patient Questionnaire
We ask you to complete our new patient questionnaire enabling our clinical and administrative staff to prepare for your first visit with our dentists in San Diego, California, Dr. David Chotiner and associates, and to make your check-in for your appointment easier and more efficient.
Our questionnaire consists of important documents that MUST be completed prior to your appointment day. To complete a document, simply fill out the fields with the requested information. While most of the fields are optional, certain fields, marked by asterisks, must be completed. When you have completed a document please review your entry, click the Submit button to move to the next document. Please don’t use your browser’s Back or Forward buttons as use of these buttons may ‘undo’/’redo’ your recent actions and may result in errors.
Please note that the information you submit will be encrypted for your protection and goes directly to our office. We appreciate the time that you will spend providing the information helping us prepare for your visit.
To start, please click the Start button below.
Thank you, and please call Coastal Dental Arts at (619) 858-8080 or contact us below if you have any questions.
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