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Patient Forms

Our New Patient Forms are now available online! We are proud to make our patient forms available online so you can complete them at your leisure – saving you time in our office and giving you time to carefully review our policies and procedures. If you would like to complete the form before arriving at our office, please click the icon below to download the form in PDF format. Please fill out and email new patient form to You may print forms for your records.

To schedule an appointment you may call our office at (858) 412-5155 or complete the appointment request form to the right. We will then contact you within one business day to reserve and confirm your appointment.

If this is an emergency, or if you are trying to cancel or change an existing appointment, please do not use this form. Contact us by phone at (858) 412-5155        

Appointment Request

EDENT, Shira Shasho DMD

Pacific Beach Cosmetic & General Dentistry

1038 Grand Ave

San Diego, CA 92109

(858) 412-5155