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Dr. Fatima
Downloadable Forms

New Patient Forms

These forms can be completed by printing and bringing them with you on your first office visit.

Health History Form
Patient Information Form

HIPAA – Notice of Privacy Practices 
 

HIPAA – Acknowledgement of Privacy Practices

At the office of Dr. Fatima Justiniano, we’re dedicated to caring for your family’s smiles with a focus on prevention, gentle treatments, and beautiful results. Conveniently located in Newark, CA.

Services

  • Tooth Whitening
  • Tooth Discoloration
  • Sealants
  • Scaling and Root Planing
  • Root Canal Treatment
  • Periodontics
  • Pediatrics
  • Orthodontics: Braces and More
  • Oral Surgery
  • Invisalign

Useful Links

  • Services
  • Smile Gallery
  • Our Staff
  • FAQs

Info

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  • Terms & Conditions

Copyright 2005-2025 - FJDentistry and Fatima Justiniano Dentistry.
All rights reserved.

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  • Home
  • About Us
  • Our Staff
  • Patient Education
  • Forms
  • FAQs
  • Contact