Patient Forms

Serving Thousand Oaks, Thousand Oaks, Simi Valley, Moorpark & Westlake

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Patient Forms



Here at Village Family Dentistry of Thousand Oaks, CA, we are dedicated to providing you with the best and affordable dental care. We always welcome new patients, and would like to thank you for referring family and friends to our practice.

Please download, fill out, and bring the patient form with you on your next visit.

Download Patient Form

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options.

Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation if possible:

  • Your referral slip and any X-rays if applicable
  • A list of medications you are presently taking
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
  • Please fill out our patient form and bring it on your next visit to save your time in the office.

For New Patients


Office Hours

Mon - Thu: 9AM - 6PM
Sat: 11AM - 4PM
Our Patients Love Us!

Village Family Dentistry

Address: 166 N Moorpark Rd #204, Thousand Oaks, CA 91360
Phone: 805.777.7717
Email: info@villagefamilydentistry.com

Office Hours

Monday - Friday: 9AM - 6PM
Saturday: 11AM - 4PM

Village Family Dentistry

Address: 166 N Moorpark Rd #204, Thousand Oaks, CA 91360
Phone: 805.777.7717
Email: info@villagefamilydentistry.com

Office Hours

Monday - Friday: 9AM - 6PM
Saturday: 11AM - 4PM