Forms for Download

 

Please use the following links to download the appropriate form, print the form, sign the document and fax or email it to Dr. Westerhaus who will contact you.  Please also bring them with you on the day of treatment. 

Adult Patient Forms

 

 

  • Please contact us for a fee estimate. 

Pediatric Patient Forms (Age 12 and under)

 

 

  • Please contact us for a fee estimate.

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

Mobile anesthesia and IV sedation for the communities of Northern California

Sacramento, Central Valley and the Bay Area 

 

©David Westerhaus DDS INC. All Rights Reserved.