Call: (909) 435-4558
303 Brookside Ave., Redlands, CA 92373 | Directions

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

promotional Offers
As one of our new patients, you are entitled to the following:
Professional Teeth Whitening - $89
Custom Trays
We know you have many choices when it comes to dentistry. We extend these offers as way of saying

"Thank you for joining our practice".
Pure Gold Professionals in Dentistry
5
Dr- Terry L Vines. Reviewed by
"Best dentistry in town. My whole family goes to them. Very friendly staff, great doctors & professional hygienists. Worth the drive from Upland to Redlands."
Appointment Request
Now we accept care credit as a
payment option

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