596 Bellevue Rd. Atwater, CA 95301


New Patient Package
Existing Patients Call   209.358.0800

Use your benefit before it expires at the end of year
Friday and Saturday appointments upon request
Please call 358.0800 to schedule your next appointment

We are asking you to complete new patient package enabling Dr Eric Cheung and his team to prepare for your first visit and to expedite your check-in for your appointment.

Our package consists of 8 documents. To complete a document, simply fill out the fields with the requested information. Keep in mind some mandatory fields are marked by asterisks. If there is a blank mandatory field, the website will remind you before going to the next page or next document.

When you have completed a document please review your entry, then click the Submit button to move to the next document. Please use “Previous” in the webpage to go back to correct information. Please DO NOT use your browser's Back or Forward buttons. Use of these buttons may 'undo'/'redo' your recent actions and may result in errors. Instead, you can use “Previous” to go back to fill in the correct information.

Please note that the information you will submit will be encrypted for your protection and goes directly to our office. We appreciate the time that you will spend providing the information helping us prepare for your visit.

Thank you and please call our office (209) 358-0800 or email to ddsericcheung@gmail.com if you have any questions.


Here are some tips. If you have any difficulty, please come back to this page and read the remaining tips.

1. There are two online packages. The first document focuses on your personal information. The next 7 documents will be a bunch of readings. The link will either pop up or open a new tab on your browser. Feel free to come back to this page for clarification or tips.

A. The full package has 8 documents. (Highly recommended)

Full Package

B. The lite package just asks for patient and health history. Then please be in our office 10-15 minutes before your appointment so you can read over the other 7 documents and sign in our office.

Partial Package


2. The first page looks something like this


3. At each page, you should see Atwater Family Dental, our logo, Eric K. Cheung DDS and our phone number (209)-358-0800. And also at the bottom of the page should read “Atwater Family Dental”


A. Some text boxes let you fill in the information.

B. Clicking some box such as “Family Status” will show different options/answers.

C. “Student status” If you are not a student, please select “non student” then the question about school will disappear.


5. Please note the “Continue” button is on the left and the “previous” button is on the right.


6. After reviewing your entry, click “submit”

After each document, the following message will show:

Then go ahead to click on “here.” and please don't use your browser's back button.


7. For the next series of documents, please enter your name on each document.


8. Signature
If you are using a PC to sign, left click and hold and move the mouse to sign.

If you are using a mac, click and hold the trackpad and move your finger to sign.

If you are using a mobile device, touching within that signature box will let you start signing.


9. HIPAA Acknowledgement Form
Click on the link “HIPAA Notice of Privacy Practices.” to read the file. A new window will pop up. Make sure you come back to the original browser to finish the document.


10. At the end of all documents, you will see the following message:


11. Remember, you just need to click one of the two links below.

Full Package


Partial Package


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Dr. Eric K. Cheung D.D.S.

596 Bellevue Rd.
Atwater, CA 95301


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