Patient Forms

More Convenient Patient Forms

Please print and fill out the following forms to bring with you to your appointment.

Dental History
Medical History
New Patient Form
Notice of Privacy Practices

After you’ve filled out the forms, schedule a consultation with Dr. Kania by calling her periodontal office in Encinitas/San Diego, CA, at (760) 642-0711.

LANAP

Laser-assisted periodontal maintenance with the LANAP protocol for more comfortable and precise treatment.

OZONE THERAPY

A holistic, oxygen-based therapy that neutralizes the harmful oral bacteria responsible for periodontal disease.

PRP & PRF

Platelet-rich plasma and platelet-rich fibrin promote the natural growth and repair of damaged periodontal tissues.

PST™ GRAFTS

The Pinhole Surgical Technique allows for scalpel-less gum grafting for optimal results and maximum tissue preservation.