All
California schools and community centers are eligible for Health Mobile services.
Find out how to arrange a visit below."We have to develop a safety net
for all our kids. They can't learn if they are physically hurting." Santiago
V. Wood Superintendent of Schools – Alum Rock School District
School administrators have reported that, as Health Mobile dentists
relieve their students' dental pain, self-confidence and motivation increases.
Improved classroom performance and increased attendance rates then follow.
To
arrange a Health Mobile visit;
Please follow the instructions below.
The
process is simple and efficient, as we are anxious to bring our program to
you.
Contact Director of Patient Relations at Health Mobile, at (408) 879-0110 to
schedule a visit.
Download the Application Form and the Patient Medical History Form.
Photocopy and
distribute both forms to all interested
individuals.
Application and Consent Form ( English) (Spanish) (Korean)
Patient Medical History (
English) (Spanish) (Korean)
Fax the completed Application forms to:
Director of Patient
Relations Health Mobile at (408) 244-9553 or,
you can mail them to:
Health Mobile
1659 Scott Blvd. Suite 4,
Santa Clara, CA 95050.
Note: The Patient Medical History forms will be available at the Mobile and
can be completed by the patient before his or her appointment.
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