Kurt Hummeldorf, DMD-PC Online Patient Registration

Oral Surgery Patient Registration In San Diego CA

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration

Patient HIPAA Consent Form

Financial Policy Form

Please be aware that Dr Hummeldorf does not accept medical insurance plans for services rendered in our offices. Please do not fill out the medical information in patient registration, this could delay your dental insurance benefit.

Call San Diego Office Phone Number 619-282-7088 with any questions about completing our registration form.

New Patient Information

Thank you for choosing Kurt Hummeldorf, DMD-PC. We strive to deliver the best diagnosis and treatment that our practice has to offer. We believe that these goals can be met through a continuous and open dialogue between you and our entire team.