Logo of Jacqueline Younesi dentistry.

(949) 409-9895
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Mon - Th: 7:00 AM - 4:00 PM
Fri/Sat/Sun - App Only

Jacqueline Younesi Dentistry Forms

Thank you for your interest in our office. We are looking forward to meeting you.

Below is our New Patient Packet.

Please fill out all of the pages and either bring them with you to your initial appointment or email them to us prior to office@jyounesidentistry.com, and please let us know if you have any questions!

Looking to make an appointment? Click here!

Looking to make an appointment? Click here!

  • Notice of Privacy Practices

    This Notice describes how your health information may be used and disclosed and how you can get access to this information. Please review it carefully. The privacy of your health information is important to us.

  • New Patient Form

    For your convenience we have provided our New Patient Form page for you to fill out in advance.