Patient Information

When you arrive at our Roseville dental office for your first visit with Galleria Smile Designs, please be prepared to complete all new patient forms that will allow us to begin your dental treatment. We may ask you to fill out several forms that will get you acquainted with our office.

We take pride in making your dental experience as pleasant and comfortable as possible. We will thoroughly present treatment options, fully explain our procedures and provide customized instructions for you to maintain your oral health. It is our goal to have you feel secure in the treatment of your dental needs at Galleria Smile Designs.

Patient Forms

To help streamline your first visit we’ll send you an email or text (whichever you prefer!) with our New Patient Forms. All you have to do is open the link, sign in using only your last name (this is case sensitive!) and birth date and fill out the forms. Quick tip: the link will expire. After you hit submit, the forms come back directly to our office. Every step is secure and encrypted, we value your privacy and time. Thanks for helping make your first visit a wonderful experience!

For help, don’t hesitate to call our friendly front office team at 916-532-1635.

Financial Policy

We strongly believe you shouldn’t have to worry about what your insurance covers or deal with financial barriers to obtain the proper treatment of care. We accept major PPO plans plans and are not contracted with DeltaCare, Delta HMO or any medi-cal dental benefits

Don’t see your insurance on this list, don’t worry. We offer a unique Membership Discount Plan to ensure you can afford the quality care you deserve. Reach out to our office to schedule an appointment today!

Don’t see your insurance on this list, don’t worry. We offer payment and financing options to ensure you can afford the quality care you deserve. Reach out to our office to schedule and appointment today!

Patient Release Form

Download the Release of Records Consent Form

 Download form in PDF

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