Our office accepts new patients. A referral from a dentist is not required. We receive many referrals from our loyal patients of record.
To help us treat you safely, we request that you complete the patient information form. To save you time, you may download our online patient information form, print it, and fill it out at your convenience before your appointment. This PDF form can be opened with Adobe Acrobat Reader 7.0 or later (free if you don’t already have it).
Just print the form and fill it out. The form can be mailed or faxed to 909-981-2149.
Thomas J. Kepic, DDS, MSD
250 East 7th St., Suite D
Upland, CA 91786
FAX COMPLETED FORMS TO: 909-981-2149