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Your First Visit

Your initial visit to our office allows us to learn about you and your specific orthodontic concerns. Prior to your complimentary consultation, we will give you a brief tour of our facilities and introduce you to our team. We also ask you to complete a Medical Health History and New Patient Enrollment Form. For your convenience, you can download the form below in advance of your first visit and type in your information.  You have the choice of either printing it out and bringing it in with you or you can also email it to us.   To download the form, click on the file that applies to you below.

At your consultation appointment, we will discuss your concerns and potentially gather other critical diagnostic information, including:
• Digital photos
• Digital x-rays
• Important jaw measurements
• Digital casts of your teeth and bite

Information from your first visit, when combined with input from your general dentist or referring specialist, will allow Dr. Karkhanechi to prepare your individualized and comprehensive treatment plan.  The doctor and our knowledgeable treatment coordinator will discuss treatment details with you, and assist you in scheduling a follow-up appointment to get started.


Please see below for new patient forms. If you have any questions or concerns while filling these out, please do not hesitate to contact our office and the front desk staff will be able to assist you.


Child - New Patient Form

Adult - New Patient Form

New Patient Insurance Information

New Patient Insurance Authorization Form



San Ramon Orthodontics
2305 Camino Ramon, Suite 260
San Ramon, CA 94583
Phone: 925-829-1100
Fax: 925-829-1128

Office Hours

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