Below you will find a link to the New Patient Appointment Request Form and all of the required new patient forms.

Each person needs to complete the New Patient Appointment Request Form (completed online through Google Forms) and one of each of the following forms; Adult/Child Registration - (adult is considered 14 years and above), Medical History, Dental History, Request for x-rays, Referral Form and Acknowledgement of Receipt (for any patients under the age of 18 needs to be signed by the legal guardian). The forms can either be emailed to us at [email protected]; faxed to us at 408-253-6341 or they can be brought into our office at Murray Dental Care, 10055 Miller Ave. Ste. 104, Cupertino, CA 95014.

Our Office


10055 Miller Ave, Suite 104, Cupertino, CA 95014

Working Hours:
Monday: 8:30 am - 5:00 pm
Tuesday: 7:30 am - 3:00 pm
Wednesday-Thursday: 8:00 am - 5:00 pm
Friday: 8:00 am - 2:00 pm
Saturday-Sunday: Closed