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The following links lead to Health History forms & Children's Health History forms. Filling these forms out ahead of time will make your first visit to the dentist one step easier!

: Health History Form
: Children's Health History Form
: Please fill this survey out and bring it with you to your next dental appointment for a free smile analysis!
 

Rafi Balabanian DDS, FAGD
1961 Pruneridge Avenue
Suite #A
Santa Clara, CA 95050
(408) 985-7234 
rafibal@aol.com 

 
Rafi Balabanian, D.D.S.
1961 Pruneridge Avenue, Suite A
Santa Clara, CA 95050
Phone:408-985-7234
Fax:408-985-4212
rafibal@aol.com

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