Patient Forms

Patient Forms

Please click on the link below to download our forms. Please print and complete the forms prior to your appointment and bring them with your insurance card to your appointment.

If you are unable to print the forms, please plan to arrive 10-15 minutes early for your appointment so that you can complete them in our office.

New Patient Medical History Form
Office Guidelines
Getting to Know You

Call or Click Today

Use Our Online Request Form

Hours

Monday - Thursday 8am-5pm
Friday - Sunday Closed

Call Us

Tel: (916) 483-7459
Fax: (916) 483-0604

M.J.

From our verified Google & Yelp reviews
I have been seeing Dr Mark for over 20 years. I won't go anywhere else. He does great work that has stood the test of time.

Kim S.

From our verified Google & Yelp reviews
Excellent service as always. Highly recommend Dr. Kujiraoka as your personal dentist. He's an excellent practitioner, knowledgeable, highly skilled and very personable. His staff is always friendly and helpful.

Nina J.

From our verified Google & Yelp reviews
I was completely unprepared for my appt today.  I got a 30 minute text from the office when I was on my way to a medical appt (that appt is actually tomorrow morning...i got that mixed up).  Needless to say, I was really tense Yet and still, another cavity gently filled by Dr. Kujiraoka.  Thank you, Dr. Kuji!

Robyn V.

From our verified Google & Yelp reviews
Mark is the best dentist, along with the rest of the team that work for him!  Top of the art equipment and technology... I highly recommend this dental practice.  They are a terrific team!!

Abigail D.

From our verified Google & Yelp reviews
As their patient, I know I'm in the hands of an amazing group of caring and top- notch professionals.

Cyndi S.

From our verified Google & Yelp reviews
Dr. K and his staff are seriously the nicest, best dentist and staff in town.

Brenda S.

From our verified Google & Yelp reviews
I have been a patient of Dr Kujiraoka for at least 20 years. He is an excellent dentist and has always had the most up-to-date equipment. The environment is lovely and you are made to feel at home in their office.

Dao V

From our verified Google & Yelp reviews
Great start so far. This was my first visit to this dentist and so far this is best dentist I've been to. Dr Kuj explained and answered all my questions and was very honest on certain practices that some of us would frown upon. His staff was kind and patient with me as well.. Glad I chose them.

Jeff W

From our verified Google & Yelp reviews
Dr Kukiraoka and his staff are top notch. Always very friendly on the phone and extremely helpful and dedicated to patient comfort. They called the day after my procedure just to check on my symptoms and pain levels! Highly recommended and will not go to any other dentist after my experience here.

Vlad P.

From our verified Google & Yelp reviews
Great Beautiful place! Greater when entered! Nicely dressed staff! Very Welcoming! Got a tour of the office! Very educated Dentist and staff! Had X-ray and exam, with a cleaning from wonderful hygienist Jenny! The place to go for your teeth!

3840 Watt Ave Bldg. D
Sacramento CA 95821