New Patient Registration Form English
New Patient Registration Form Español

Background Information

Oral and maxillofacial surgery requires additional years of hospital-based surgical and anesthesia training after graduation from dental school. As an oral and maxillofacial surgeon, Dr. Thiede manages a wide variety of problems relating to the mouth, teeth, and facial regions.

Dr. Thiede practices a full scope of oral and maxillofacial surgery with expertise ranging from dental implant surgery and wisdom tooth removal to corrective jaw surgery. This also includes techniques designed to rebuild bone structure with minimal surgical intervention and optimal patient comfort. Our office can also diagnose and treat facial pain, facial injuries, and fractures.


Financial Information

Payment Options

For your convenience, we accept Visa, MasterCard, American Express and Discover. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance.

We also offer the convenience of CareCredit, Allegro, Lending Club and Cherry for monthly payment plans.

If you have questions regarding your account, please contact us at 1-714-730-6767. Many times, a simple telephone call can clear up any misunderstandings.

Please remember that you are fully responsible for all fees charged by this office regardless of your insurance coverage.

Billing Information

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect payments made by your insurance company during that time period. Any remaining balance after your insurance has paid its portion is your responsibility. Your prompt remittance is appreciated. Please ask our staff for more information via email or 1-714-730-6767


Insurance Information

We make every effort to provide you with the finest care and the most convenient financial options. To accomplish this we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures.

If you have any problems or questions, please ask our staff. They are well informed and here to assist you. They can be reached by phone at So Cal Oral and Maxillofacial Surgery office in Tustin CA 714-730-6767.

Please bring your insurance information to your first office visit so that we can expedite reimbursement.

Please call if you have any questions or concerns regarding your initial visit.


Surgical Staff

The surgical staff at So Cal Oral and Maxillofacial Surgery are experienced, certified oral and maxillofacial surgical assistants, trained in assisting with intravenous (IV) sedation and outpatient general anesthesia in our state-of-the-art office setting. Patients are continuously monitored during and after surgery.

All Staff are informed administrative personnel, well versed in health and insurance policies, and are CPR certified. We speak English and Spanish and are currently accepting new patients.


Privacy Policy

Disclaimer

Notice to Website Viewers:
This web site is provided for information and education purposes only. No doctor/patient relationship is established by your use of this site. No diagnosis or treatment is being provided. The information contained here should be used in consultation with a doctor of your choice. No guarantees or warranties are made regarding any of the information contained within this web site. This web site is not intended to offer specific medical, dental or surgical advice to anyone. Further, this web site and So Cal Oral and Maxillofacial Surgery take no responsibility for web sites hyper-linked to this site and such hyperlinking does not imply any relationships or endorsements of the linked sites.
Privacy Policy
If you require any more information or have any questions about our privacy policy, please feel free to contact us. The privacy of our visitors is of extreme importance to us. This privacy policy document outlines the types of personal information that is received and collected by us and how it is used.

Personal Information
By entering your full name, email address, and phone number, you are providing personal information that will be used by So Cal Oral and Maxillofacial Surgery for the sole purpose of returning your request to be contacted by us. We will only use this information to contact you in order to assist you in scheduling an appointment to be seen and/or to answer any questions you may have indicated in the comments section. Our intention is to only use your personal information to return your request for contact regarding a dental appointment, and/or a dental related question.

Opt-Out Option
Please contact us if you wish to opt-out/unsubscribe from receiving any future communication.

Log Files
Like many other Web sites, we make use of log files. The information inside the log files includes internet protocol (IP) addresses, type of browser, Internet Service Provider (ISP), date/time stamp, referring/exit pages, and number of clicks to analyze trends, administer the site, track user’s movement around the site, and gather demographic information. IP addresses, and other such information are not linked to any information that is personally identifiable.

Accessibility
We strive to make our website universally accessible and we are continuously working to improve the accessibility of content on our website. Below, you’ll find a few recommendations to help make your browsing experience more accessible:

If you have trouble seeing web pages, the US Social Security Administration offers these tips for optimizing your computer and browser to improve your online experience.

If you are looking for mouse and keyboard alternatives, speech recognition software such as Dragon Naturally Speaking may help you navigate web pages and online services. This software allows the user to move focus around a web page or application screen through voice controls.

If you are deaf and or hard of hearing, there are several accessibility features available to you:

Closed Captioning
Closed captioning provides a transcript for the audio track of a video presentation that is synchronized with the video and audio tracks. Captions are generally visually displayed over the video, which benefits people who are deaf and hard of hearing, and anyone who cannot hear the audio due to noisy environments. Most of our video content includes captions. Learn how to turn captioning on and off in YouTube.

Volume Controls
Your computer, tablet, or mobile device has volume control features. Each video and audio service has its own additional volume controls. Try adjusting both your device’s volume controls and your media players’ volume controls to optimize your listening experience.

If the recommendations above do not meet your needs, please contact us at 714-730-6767 for assistance.


Scheduling

If you have pain or an emergency situation, every attempt will be made to see you that day.

Please call us at 714-730-6767 with any questions or to schedule an appointment.

Appointment Policy:

We try our best to stay on schedule to minimize your waiting. Due to the fact that Dr. Thiede  provides many types of dental services, various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays. We appreciate your understanding and patience.


Online Videos

Our online videos are presented to help you understand more about the oral surgery procedures we perform. You may choose to view online videos about Dental Implant Surgery, Wisdom Tooth Extractions, Jaw Surgery, and Post-Operative Instructions

Informed Consent Presentation
Our online Oral Surgery Videos are presented in order to help you understand more about the oral surgery procedures we perform. Please click on the image to begin, and choose a specific video of interest.


First Visit

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan may require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any x-rays if applicable.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.


IMPORTANT:
 All patients under the age of 18 must be accompanied by a parent or guardian at the consultation visit.

A preoperative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink six hours prior to your surgery. You will also need an adult to drive you home.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medications (i.e., heart medications, aspirin, anticoagulant therapy, etc.).

X-Rays
If your dentist or physician has taken x-rays you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary they can be taken at our facility.


Patient Registration

Online Secure Registration
You must preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

After you have submitted your form, you will have the opportunity to securely upload and transmit an image of your insurance card or paperwork. Please call us for assistance: 714-730-6767.

Technical Note
These forms are in PDF format. If you do not have Adobe Reader installed on your computer, you may download Acrobat Reader for free and use it to access these forms.



Location

13522 Newport Avenue, Suite 109,
Tustin, CA 92780

Office Hours

MON8:00 am - 5:00 pm

TUE8:00 am - 5:00 pm

WED8:00 am - 3:00 pm

THU8:00 am - 5:00 pm

FRI7:00 am - 3:00 pm

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