Online Forms & Policies

Patient Registration Form

Dental & Medical History Form

Policy Acknowledgement

Office Financial Policies Form

Dental Materials Fact Form

Cancellation policy: Last minute cancellations are disruptive and deny other patients the benefit of receiving the care they need in a timely manner. We appreciate every effort you can make to give us as much notice as possible but at least one business day notice if you need to change an appointment. Our policy applies a $100 initial charge in the event such appointment is not kept, canceled or rescheduled with less than two full business days notice. Patients who repeatedly and exceedingly fail to show, cancel or reschedule without proper notice may be dismissed from the practice.

Payment Policies: Payments and co-payments are due in full at the time of dental services. We accept cash, Amex, Visa, Mastercard.

As a courtesy to you, should you have dental insurance coverage, we will file your claim with your insurance company as well but you are ultimately responsible for the full payment towards the dental services received. If you do not provide your current dental insurance coverage at least 2 full business days ahead of your visit, the fee for the entire visit will need to be collected at the time of service.




Read what people are saying about us.

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I never thought I would say I enjoy going to the dentist , but these two really elevate the practice of dentistry! I travel from the East Bay to attend my appointments and despite the morning traffic, I would never consider going anywhere else. Here are the things that, in my opinion, really make Dr. Ramirez and Dr. Karimi shine:
(1) They are very personable and easy to talk to - When I was looking for housing in the Bay Area, Dr. Karimi went out of her way to write down some areas for me to look. Who does that? Awesome dentists who care, that's who!

(2) They don't try to sell me services I don't need - I hate it when dentists try to sell you all sorts of fancy procedures/items you don't really need. These two would never do that!

(3) A focus on preventative care - Even though the money maker in dentistry is probably fixing bad teeth, both dentists emphasize preventative care. it's the first practice I've been to where their immediate response isn't to drill and fill!

(4) Email reminders before an appointment - I am really bad with the phone, so the email appointment reminders are a godsent!

Trina E.

Everyone in this office is FABULOUS!

My wife first heard about David and Katy through SFSPCA, and after the first appointment she couldn't stop raving about her visit! I was suspicious at first, since it's unusual to have a pleasant dentist visit. But then she went for a second visit, third visit, and the service and people were consistently excellent.

Finally I got very lucky and was able to schedule an appointment to experience this myself, and GOSH DR. RAMIREZ SERIOUSLY IS THE BEST DENTIST I'VE HAD! Super careful and professional, explained every step of the way and really funny to chat with lol

Sun, Joanne, Rita were all amazing and super helpful as well.

Thank you so much, everybody!!

Timmy Yelp H.

Dr. Ramirez and Dr. Karimi have been my dentists for almost a decade now and they are by far the best dentists I have ever had. Dr. Karimi is amazing and gives so much personal attention she makes you feel very at ease. They truly care about you and your health. Dr. Karimi has helped me over the years to have better dental hygiene and it shows in how much better my teeth have gotten the last decade. I panic about one day moving as I know I will never find a better dental office than here. They really are the best and would recommend them to anyone.

Jeff H.

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