Patient Center

Welcome to our Patient Center!


Thanks For Entrusting Us With Your Dental Care. Our San Fernando office provides dental services for patients with a large variety of insurance plans or without any insurance coverage at all. Ultra Dental offers a complete range of dental care, including general and preventative care, cosmetic and specialty dental health services.

We created this Patient Center in order to prepare you for your first or next visit. Here, you will find some online shortcuts that will save you time and make your dental experience much easier.


Our Mission Statement
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.

Driving Directions

General Patient Forms

Online Form: New Patient Registration, Dental and Medical Health History

HIPAA Consent

Financial Policy

Orthodontic Patient Forms

Orthodontic Registration

HIPAA Consent

Child Patient Forms

Dental and Medical Health History

 HIPAA Consent

Treatment Consent

 Financial Policy

Consent for Treatment of Minor Child

Designation of Another Person to Consent for Treatment of Minor Child