Smile San Clemente Dentistry
Sachiko Fukuman, DDS, Inc.
Creating Beautiful Smiles
Call: (949) 248-7772

Patient Information

New Patient FormsDownload, Print & Complete Prior To 1st Visit

Handle Me With CareDental Questionnaire


Patients are seen on an appointment basis, and we reserve time specifically for you and our professional staff. We ask that you complete an online appointment request or call (949)248-7772 in advance so that we may reserve an appointment time for you. If this is an emergency, please call (949)248-7772 immediately so that we can take care of you as soon as possible.

If you are a new patient to our office, the link above contains our new patient forms that will need to be filled out when you arrive at our office. Printing the forms, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please contact our office if you have any questions at all. (CLICK HERE) or on link above to download forms.



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