Theodore A. Tanabe, D.D.S.
Oral & Maxillofacial Surgery
Gentle and Compassionate Care
Call: (562) 698-0387

Patient Forms

The first visit to our office is designed to introduce you to Dr. Tanabe and our caring team as well as discuss your specific area of concern.  You will also have an opportunity to discuss insurance coverage and payment options with our experienced staff.  We encourage questions and do our best to always deliver quality care.  

If you would like to streamline your first visit to the office, please take a moment prior to your scheduled appointment to download the Patient Information Form that applies to you as well as the Medical History Form.  We ask that you print and complete the forms and bring them with you to your appointment so we may better assist you in a timely manner.  

It is highly recommended that patients with a complex medical history bring in a list of their prescription medications as well as contact information for their physicians.  Please be advised that in some cases Dr. Tanabe may need to discuss details of your proposed treatment with your physician prior to scheduling a date for surgery in order to give you the safest possible care.

Thank you for your confidence in our office, we look forward to bringing you into our family of patients.


Patient Information

Patient Information (Child) - for any patient that is covered by a parent's insurance

Medical History


Please review the following COVID-19 forms prior to your appointment.  We will have copies for you to sign in the office when you check in.  Contact the office if you have any questions or concerns about what we are doing to keep our patients and ourselves as healthy as possible.





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