Forms & Financing

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Online New Patient Forms

New to Mission Peak Pediatric Dentistry? We’re so glad you’re here. To help you save time at our office and enjoy a sweet, stress-free visit with your little one, we provide simple and secure new patient forms without the piles of paper. Just fill out forms from your smart device and walk into your child’s visit ready to go! Our attentive team will use these forms to personalize every detail of your kiddo’s appointment. We look forward to seeing you and your family!

Forms Coming Soon

Easy & Convenient

Referral Forms

As a local pediatric practice, our kid-friendly specialists are grateful to provide a caring, trustworthy dental home for tiny patients in Fremont. If you would like to refer a child to Dr. Michael, simply complete the referral forms below with any pertinent information and we’ll be quick to respond. You can also reach out with any questions by giving us a call at (510) 980-7325!

Referral Form Coming Soon

Keeping Care Inclusive

Our Accepted Insurances

Mission Peak Pediatric Dentistry is dedicated to delivering quality-focused, accessible pediatric dental care for all Fremont families. Which is why we accept a broad spectrum of dental insurance plans at our practice. Have any questions about your child’s treatment options? Our team is here for you! We’re always happy to help you understand and make the most of your child’s benefits, so they can receive the specialized care they need and deserve for a healthy, happy smile.