Hugh D Burke JR DDS Rancho Cucamonga Dentist

PrE-Check In
Dental Forms
Rancho Cucamonga
Rancho Cucamonga Dental
Making your smile look it's very best...
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Pre Check In Dental Forms

It is our desire to make your experience at Dr. Burke's Rancho Cucamonga Dental office as convenient as possible. So if you are a new patient and you would like to download our patient forms and complete them at your leisure, please select from the available forms below.

Each form is available as a Microsoft Word document or a PDF. You can print a copy at home and fill in the information at your convenience. Then just bring the completed forms with you to our Rancho Cucamonga dentist office for your appointment.

* New Patient Registration Form: PDF | MS Word

* New Patient Dental History Form: PDF | MS Word

* New Patient Medical History Form: PDF | MS Word

We know you have many choices in Rancho Cucamonga when deciding who to trust your families dental care to. The entire team at Dr. Burke's office will treat every member of your family just as if you are part of our family, every time you visit us for an exam.

Schedule you for an appointment right away in our Rancho Cucamonga office. Call us today at 909-945-2342

If you have a Dental Emergency and can not wait until normal business hours to be treated by our dentist then please call our emergency number at 909-228-2082 and someone will get back to you right away.


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Rancho Cucamonga Pediatric Dentist

Pediatric Dentistry For Your Kids We understand your children are your whole world, that's why we promise to treat them just like you would, if you were a pediatric dentist. Our Pediatric Dentistry team are the best in Rancho Cucamonga!

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Dental Services

I have been trusting Dr. Burke with my dental care for 12 years. He is always so gentle and he makes me feel like one of the family everytime I come in for a dental exam...
Mr. Brandon Schulze

Your Dental Health is Our Goal!