Patient Forms, Map and Directions to Billerica Office
Your first visit to One Dental Care - Kunio Chan, DMD, MAGD establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You’ll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There’s also background information about our committed staff and our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.
Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
We can mail, email the new patient forms to you directly as well, please tell us your preference when you are booking your first appointment with us!
- Patient Registration Form
- Medical History Form
- Dental History Form
- List of Medications
- Financial Policies Form
- Office Policies and Consents Form
- Notice of Privacy Practice - You can read it online without printing it if you do not want a paper copy
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
First Visit as an Adult
It usually takes 90 min to 2 hours for the initial visit and that includes taking necessary x-rays, clinical photos, TMJ evaluation, oral cancer screening, extra and intra oral examination. Impressions of your teeth might be taken if we need to gather more information for your treatment planning. After we gather the facts and the data, depending on the complexity of the case, we may need to schedule a separate session to present to you treatment plans that suit your needs. "Dental Cleaning" usually will NOT be performed during the first visit because we need to evaluate your gums and bone condition first to determine what type of periodontal treatment will be most suitable to you. Dental Cleaning can be done with the treatment planning session if we find out you have healthy gums and bone.
If you have orthodontic problem and you want to seek treatment, you may need an extra half an hour (a total of 2 to 2.5hrs) to our first visit appointment to collect more orthodontic data for your future orthodontic consultation appointments.
First Visit as a Child or Adolescence
It usually takes 60 - 90 min for the initial visit and that include taking necessary x-rays, extra and intra oral examination, dental cleaning and topical fluoride treatment. The more dental problems your child has, the older the child, the longer the appointment time will be. An adolescences that are 16 and above will also receive oral cancer screening. If his/her age is close to be an adult with complex dental issues, his/her first visit will take as long as a regular adult (90 min without dental cleaning).
If your child has orthodontic problem and wants to seek treatment, you may need an extra half an hour (a total of 90 - 120 min) to our first visit appointment to collect more orthodontic data for your child's future orthodontic consultation appointments.
First Visit as an Infant or Toddler
It usually takes about 30 -60 min for the initial visit and that will include taking necessary x-rays, extra and intra oral examination, dental cleaning and topical fluoride treatment. Same as all other age groups, the need of x-rays and topical fluoride treatment is determined by individual patient's risk factors. At this age group, we mainly focus on the parents or caregivers' infant/toddler oral hygiene instructions. We also want the child to get used to seeing the dentist regularly at an early age.
According to the guideline from the American Academy of Pediatric Dentistry, infants should have their first dental visit no later than their first birthday.