Please click here to download a Medical History Form

You must have Adobe Acrobat Reader to view and print the Medical History form
Click here for a free version of Adobe Acrobat Reader

Please print this form and mail or fax it to Dr. Wheeler's office:
FAX:760-942-0331
 
Stephen L. Wheeler, D.D.S.
Scripps Medical Office Building
320 Santa Fe Drive Suite 304
Encinitas, CA 92024

 
Last Modified :02/06/07 Copyright 2006