A to Z Pediatric Dentistry

Joel R. Clark, DDS

Trevor M. Jensen, DDS

Jaiden Mercer, DMD


MESA: (480) 503-FROG
GILBERT: (480) 840-6003
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Patient Forms

First Visit

  • New Patient Registration
  • Financial Policy & HIPAA
  • No-Show/Cancellation Policy

Other Forms

  • Important information to read the day before your sedation appointment for your child
  • Post-Op Instructions for Oral Sedation
  • Chart Release Form
  • X-ray Release Form

Primera Visita

  • Forma de Registración del Paciente
  • Política Financiera & HIPAA
  • Póliza de Citas Canceladas

Otras Formas

  • Que puede pasar durante el día que reciebe sedación su niño/a

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Mesa Office

P: (480) 503-3764
F: (480) 380-0336
MESA STAFF EMAIL

 

1810 S. Crismon Rd.
Suite #189
Mesa, AZ 85209

Office Hours
Mon – Thu 7:30a-4:30p
Fri 7:30a-12:30p

Gilbert Office

P: (480) 840-6003
F: (480) 840-6032
GILBERT STAFF EMAIL

7400 S Power Rd.
Suite #132
Gilbert, AZ 85297

Office Hours
Tue – Thu 7:30a-4:30p
Fri 7:30a-12:30p

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