• Berkeley and Orinda Orthodontics Patient Screening Form

    Thank you for taking an active role in helping Berkeley and Orinda Orthodontics protect our patients and staff from COVID-19. Please complete this short form prior to your scheduled appointment.
  •  -  - Pick a Date
  • Clear
  • The doctors and staff at Berkeley and Orinda Orthodontics thank you for your efforts. - Drs. Kasrovi, Meyer, Kim, Ung, Hoang, and Ting

  • By clicking submit, I acknowledge that Berkeley and Orinda Orthodontics will use this information to comply with the California Dental Board screening requirements. 

  • Should be Empty: