Patient Registration
New Patient Forms
You may pre-register with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. Once you have completed the Registration Form, please contact the office to schedule your appointment. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. **NOTE: They will be a $50.00 Cancellation Fee if you cancel, no-show or re-schedule the consultation appointment with less than a 72 hour notice**
HIPAA Form
You may preregister with our office by filling out our secure online HIPAA Form Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Our office is located at 1663 Dominican Way, Suite 112, Santa Cruz, CA.
- Get driving directions
- Meet Dr. Cheng and Dr. Khalilzadeh
- Office Hours: Monday through Friday 8:00 AM until 5:00 PM.
Call or email us today with any questions!
Santa Cruz Oral Surgery Office Phone Number 831-475-0221 Email Us