Camelback Periodontics P.C.
Dr. Saul E. Grajales D.M.D., M.S.D.
Promoting healthy gums and teeth

Online Registration & Practice Forms

To complete your forms online, click the button below to register using our online patient portal:

 

Patient Information Forms

Medical History  Patient Responsibility Form   HIPPA Form 

Instructions after Periodontal Surgery 

Instructions after Sinus Lift Procedure

Instructions after Dental Implant Surgery

Instructions after Surgical Extraction

Instructions after Biopsy 

Instructions before IV Conscious Sedation

Instructions after Gingival Augmentation Procedure (Gum Grafting)

Instructions after Crown Lengthening Procedure

 

Patient Information Forms (Spanish)

Historial Medico en Espanol  Responsabilidad Financiera del Paciente HIPPA en Espanol  

Instrucciones despues de Cirujia Periodontal  

Instrucciones despues de un Injerto de Encias (Gum Grafting)

 

 

Testimonials

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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Office Location

  • Phoenix
  • 4202 N 32nd St
  • Suite D
  • Phoenix, AZ
  • 85018
  • Map & Directions
  • Call: 602-956-0650