New Patients

Thank you for choosing Rafati Orthodontics! Download and print new patient forms below.

New Adult Patient Forms:

New Minor Patient Forms:

Existing Patients

Thank you for choosing Rafati Orthodontics! If you have visited Rafati Orthodontics previously, see below.  

Existing Patient Forms:

Referring Doctors

 Referring Doctors Forms:

Give us Feedback

To provide the quality of services you expect, we are open to your feedback and suggestions about your recent visit or experience with Rafati Orthodontics. If you have had an enjoyable experience, let us know. If you have had an unfavorable experience, please share your thoughts on how we might improve our services. Your feedback is valuable to us, and we will do our best to accommodate your requests. Please fill out the form below and include contact information, so that we may contact you to address any outstanding issues.

Visit Our Office

San Jose, CA

827 Blossom Hill Rd., Suite E2, San Jose, CA 95123


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Office Hours

  • MON - THU10:00 am - 6:00 pm
  • FRI - SUNClosed
(408) 226-1234