Call Us Today!

(619) 465-5252

New Patients

Thank you for choosing A Shop for Smiles – Richard Hagstrom, DDS!

Here are your new patient forms:

Please use the following link below to securely fill out all of our new patient forms online at your convenience.

These forms will automatically be included in your file at our office without the need to use paper!

Please click on link below:

New Patient Forms

Please note we will review these forms in the office where you will be able to sign them personally.

Thank You!

Existing Patients

Hello and thank you for taking the time to update your Health History and Patient forms and information.

We are doing our best to not only go “paperless” but, to also keep all of your personal and medical information in a safe and secure area that can be accessed only by “securely logged in” members of our dental team to be sure you are taken care of and above all safe at all times during your dental care.

The more efficient we are with keeping your information up to date and secure, the smoother your dental visits will go, with everything from medical history and drug interactions to the correct billing of your dental treatment. Rest assured that your information is always secure and is only transferred from this link to our server in the office. No information is left on the internet!

So please follow the link below to update all of your information:

Existing Patient Login


NEW PATIENT ONLINE OFFER
Only $99
for new patient appointment, includes full mouth x-rays, digital photos, oral cancer screening and comprehensive exam. Contact Us Today For Details

CONTACT US

This Form is for
New Patients/Existing Patients Only!
Please No Soliciting
We Will Not Respond to Soliciting!

NAME:

EMAIL:

PHONE:

MESSAGE:

View our privacy policy

Richard J Hagstrom, DDS
8923 La Mesa Blvd
La Mesa, CA 91942
Phone: (619) 465-5252
Fax: (619) 462-8222