New Patient Forms

New Patient Forms

Please take a minute to fill out the following secure patient forms before your first visit:

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Medical & Dental History - Children

Child Form
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Medical & Dental History - Adults

Adult form

Get in Touch!

707-525-1180

95 Montgomery Dr # 220 Santa Rosa, CA 95404

New patient? Special offer here!
Chat with us
Welcome to Victoria Lynskey!
We are open and offering complimentary new patient consultations.
How can we help?
I'm considering treatment
I’m a patient and need assistance
Excellent, I can help!
Good news, We're are now offering both free Virtual and In-Office Consultations
PLUS, we have a limited time special offer for you.
Just by chatting here we’re both saving valuable time, so you've just earned a $250 credit toward treatment!
Use this promo code: SMILE and click one of the options below here to redeem your $250 credit and let us know what you are comfortable doing next:
I'd like to set up a virtual consultation
I'd like to set up an in-person consultation
I have a quick question - click to call Victoria Lynskey