Pleasant Smiles 9530 S. Eastern Ave. #160 Las Vegas NV 89123 (702) 450-3371

Complete General Dental Services. Emergency Dentistry, Dental Reconstruction, Tooth Extraction, Cosmetic and Immediate Implants.

Patient Forms

Let’s get that paperwork out of the way​

Quality Dentistry - FORMS


There are a total of 5 (five) FORMS TO BE COMPLETED. You’ll need to provide contact information, insurance information, health and dental histories plus a list of current medications.

Time to complete: About 15 minutes