Patient Registration

Dr. Zak Long Beach Dental Care Patients

Need to see a dentist? Requesting an appointment at Dr. Zak Dental Care office is now easier than ever. Just fill out the form using the link below and we'll contact you to confirm your actual appointment details.


When you submit personal information, we offer the secure server. The secure server software (SSL) encrypts all information you input before it is sent.

Download Patients Forms for Dr. Zak Long Beach Dental Care Office

All Patients Forms are provided in pdf format. Use the link below to complete the form, and bring it with you! We look forward to seeing you in our Long Beach dental office!

To view the dental forms you must have Adobe Acrobat Reader installed. If you don't have it, please install Adobe Acrobat Reader by clicking on the link.

Call 562-444-5959 to make an appointment,

or contact us using this form: