(949) 833-8020
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Dr Brown and Kirshner

The Office
• Meet the Dentists
• Our Staff
• Patient Testimonials
• Make an Appointment
• News

Our Services
• General Dentistry
• Same Day Crowns
• Custom Mouthguards
• TMJ - Bruxism
• Dental Implants
• Veneers
• Teeth Whitening
• Other Services
• Photo Gallery

Sleep Apnea Treatment
• Who Needs It?
• Oral Sleep Appliances
• CPAP Mask Alternatives
• Sleep Questionnaire
• FAQs
• Schedule Consultation

Helpful Information
• New Patients / Forms
• Schedule Appointment
• Get $25 Off Discount
• Affiliations
• Map and Directions
• Contact Us



Conveniently located
near the Irvine Spectrum


(949) 833-8020

Patient Forms

New Patient Forms
Please print forms, fill out all sections and bring into the office on your next appointment. If you are in need of assistance, call our helpful staff at 949-833-8020. Please do not e-mail the forms back to the office. These should only be printed.
New dental patients:
  • All New Patient Forms



    • New sleep apnea patients:
  • Sleep Screening & New Patient Forms
  • Sleep Questionnaire




    • Other forms
  • Reeval Questionnaire - Returning Sleep Apnea Patients
    •
  • TMJ and Sleep Apnea Questionnaire
    		•

    We require 48 hours notice for all cancellations.


    Schedule Appointment
    Get $25 Off Discount
    Contact Us

    To schedule an appointment at our Irvine office, please fill out the request form below. We will make our best effort to book your appointment within your preferred appointment time. We will call to confirm your appointment time upon receiving your request. You may also call or email us at (949) 833-8020 or office@brownkushner.com.

    All appointments are at our Irvine Dental Office in Orange County, CA.

    Preferred Date & Time:
    First Name:
    Last Name:
    Daytime Phone:
    Alternate Phone:
    Email:
    Sleep apnea patient? Yes
    Comments:
       * All fields are required



    © 2006-2010 Dr. Kushner & Dr. Brown