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  • Home
  • About
    • Meet The Doctors
    • Meet the Staff
    • Our Practice
  • Our Services
    • Cosmetic
      • Bonding and White Fillings
      • Inlays and Onlays
      • Lumineers
      • Snap on Smile
      • Veneers
      • Whitening and Bleaching
    • Dental Implants
    • Pediatric
      • Mouth Guards
      • Sealants
    • Periodontics
      • Arestin
      • Frenectomy
      • Gingival / Gum Grafting
      • Periodontal (Gum) Disease
      • Scaling and Root Planing
    • Restorative
      • Bridges
      • Dental Crowns
      • Dentures
    • Oral Surgery
      • Bone Grafting
      • Extractions
      • Wisdom Teeth
    • Orthodontics
      • Clear Braces
      • Invisalign
      • Night Guards
      • TMJ
    • Root Canal
  • Patient Resources
    • New Patient Forms
    • Dental Surgical Instructions
    • FAQ
    • Post-Op Instructions
  • Gallery
  • Contact Us
714.532.1139
  • Home
  • About
    • Meet The Doctors
    • Meet the Staff
    • Our Practice
  • Our Services
    • Cosmetic
      • Bonding and White Fillings
      • Inlays and Onlays
      • Lumineers
      • Snap on Smile
      • Veneers
      • Whitening and Bleaching
    • Dental Implants
    • Pediatric
      • Mouth Guards
      • Sealants
    • Periodontics
      • Arestin
      • Frenectomy
      • Gingival / Gum Grafting
      • Periodontal (Gum) Disease
      • Scaling and Root Planing
    • Restorative
      • Bridges
      • Dental Crowns
      • Dentures
    • Oral Surgery
      • Bone Grafting
      • Extractions
      • Wisdom Teeth
    • Orthodontics
      • Clear Braces
      • Invisalign
      • Night Guards
      • TMJ
    • Root Canal
  • Patient Resources
    • New Patient Forms
    • Dental Surgical Instructions
    • FAQ
    • Post-Op Instructions
  • Gallery
  • Contact Us
logologologo
  • Home
  • About
    • Meet The Doctors
    • Meet the Staff
    • Our Practice
  • Our Services
    • Cosmetic
      • Bonding and White Fillings
      • Inlays and Onlays
      • Lumineers
      • Snap on Smile
      • Veneers
      • Whitening and Bleaching
    • Dental Implants
    • Pediatric
      • Mouth Guards
      • Sealants
    • Periodontics
      • Arestin
      • Frenectomy
      • Gingival / Gum Grafting
      • Periodontal (Gum) Disease
      • Scaling and Root Planing
    • Restorative
      • Bridges
      • Dental Crowns
      • Dentures
    • Oral Surgery
      • Bone Grafting
      • Extractions
      • Wisdom Teeth
    • Orthodontics
      • Clear Braces
      • Invisalign
      • Night Guards
      • TMJ
    • Root Canal
  • Patient Resources
    • New Patient Forms
    • Dental Surgical Instructions
    • FAQ
    • Post-Op Instructions
  • Gallery
  • Contact Us
714.532.1139
  • Home
  • About
    • Meet The Doctors
    • Meet the Staff
    • Our Practice
  • Our Services
    • Cosmetic
      • Bonding and White Fillings
      • Inlays and Onlays
      • Lumineers
      • Snap on Smile
      • Veneers
      • Whitening and Bleaching
    • Dental Implants
    • Pediatric
      • Mouth Guards
      • Sealants
    • Periodontics
      • Arestin
      • Frenectomy
      • Gingival / Gum Grafting
      • Periodontal (Gum) Disease
      • Scaling and Root Planing
    • Restorative
      • Bridges
      • Dental Crowns
      • Dentures
    • Oral Surgery
      • Bone Grafting
      • Extractions
      • Wisdom Teeth
    • Orthodontics
      • Clear Braces
      • Invisalign
      • Night Guards
      • TMJ
    • Root Canal
  • Patient Resources
    • New Patient Forms
    • Dental Surgical Instructions
    • FAQ
    • Post-Op Instructions
  • Gallery
  • Contact Us

Patient Forms

Expedite Your Check-in Process

At Samira Seini Dentistry, we do our best to make dental appointments convenient and efficient as possible. We know you have more important things to do than fill out paperwork in our waiting room, so to save time, we have provided the following patient questionnaires for you to print and fill out at home before coming into the office.

Download Patient Registration Form (English)

Patient Registration Form

Download Patient Registration Form (Spanish)

Patient Registration Form - Orange Cosmetic Dentistry - Dr. Seini - California

Email Us For an Appointment

Email us and a member of our experienced and friendly staff will get back to you immediately regarding an appointment.

    Need a same-day or emergency appointment?

    Call Us Directly

    714.532.1139


    Dr. Samira Seini offers patients comprehensive dental services, including general, pediatric, and cosmetic dentistry, as well as same-day treatments and emergency dental care. Appointments are available 7 days a week, including evenings.

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    Services

    • Cosmetic Dentistry
    • Dental Implants
    • Oral Surgery
    • Orthodontics
    • Periodontics
    • Restorative Dentistry
    • Root Canal
    • View All Dental Treatments

    Office Location

    1538 E Collins Ave
    Orange , California
    Phone: 714.532.1139
    Mon – Fri: 7:00 AM – 9:00 PM
    Sat – Sun: 7:00 AM – 9:00 PM
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