Call: (909) 793 - 8837
303 Brookside Ave., Redlands, CA 92373
"I love Dr. Vines and the whole Pure Gold Dental staff. I would definitely recommend these caring and gentle people to any of my friends and family."
Michele
Appointment Request
Appointment Date *
Your Preferred Time
Your Name *
Email Address *
Your Contact Number *
( )
Your Comments *
Indicates Required *

Patient Forms

For your convenience, we have supplied forms that can be filled out on line. Click on the link below, complete the information and click the submit button. We will have them all ready for you when you make your first visit! We look forward to greeting you!

Your initial exam will last approximately one hour. Oral hygiene instructions will be provided along with suggestions to help you care for your teeth. We look forward to introducing you to our practice and provide you with our excellent care!

» New Patient Registration Form