Patient Resources
American Academy of Pediatric Dentistry
211 East Chicago Ave, Ste 1700
Chicago, IL 60611-2663
(312) 337-2169
California Society of Pediatric Dentistry
P. O. Box 221608
Carmel, CA 93922
(831) 625-2773
American Board of Pediatric Dentistry
325 East Washington St, Ste 208
Iowa City, IA 52240-3959
(800) 410-1250
American Association of Orthodontists
401 North Lindbergh Blvd
St. Louis, MO 63141-7816
(800) STRAIGHT
American Academy of Pediatrics
141 Northwest Point Blvd
Elk Grove Village, IL 60007-1098
(847) 434-4000
Pacific Coast Society of Orthodontists
401 North Lindbergh Blvd
St. Louis, MO 63141
(888) 242-3934
New Patient Registration Forms Please Read the Following Instructions:
Adobe Acrobat Reader Required.
Click the Hyperlnk below and you will be forwarded to the forms directory.
Once in the Directory:
Click on the File- "DrLeeHealthHX.pdf"
The form will open in browser.
There are 2 Ways to Fill Out This Form:
1. Manually:
Print Form and Fill Out By Hand.
or
2. By Computer:
Turn On Highlight Fields and Complete. Once Completed Print Form.
II. If Your Child Has Previously Seen a Dentist:
Please Foward Your Child's Dental Records to Our Office by Downloading and Filling out the New Patient Dental Records Release Form and Sending it to Your Child's Former Dentist.
Click the Hyperlnk below and you will be forwarded to the forms directory.
Once in the Directory:
Click on the File- "DrLee_NewPt_RecRelease.pdf"
The form will open in browser.
Print Form and Fill Out By Hand.
Contact Us
Jonathon Everett Lee, D.D.S., Inc.
Brian D. Lee, D.D.S., M.S.D., Inc.
1291 East Hillsdale Blvd.
Suite 100
Foster City, CA 94404
Phone: 650-574-4447
Fax: 650-574-4041