Pacific Oral Surgery

Pacific Oral Surgery

Simi Valley Office
2655 First Street Ste 340
Simi Valley, CA 93065
805-522-2700
Thousand Oaks Office
307 South Moorpark Rd.
Thousand Oaks, CA 91361
805-497-8571
Ventura Office
6555 Telephone Rd, Ste 1
Ventura, CA 93003
805-650-1840
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      • James O. Jacobs, DDS, MS
      • Sebastian R. Carlson, DDS, MD
      • Richard H. Bruckner, DDS
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      • James W. McLeod, DDS – Retired
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Patient Information for Pacific Oral Surgery

Please read the following patient information for your upcoming visit with Pacific Oral Surgery.

Thank you for choosing Pacific Oral Surgery for your oral surgery care needs. The doctors of Pacific Oral Surgery are dedicated to providing the highest standards of care by offering the most technologically advanced treatments available. We have offices located in Thousand Oaks, Ventura, and Simi Valley, California.

  • Patient Information Patient Registration Form OnlinePatient Registration Form Online
  • Patient Registration Form PDF Download Print Version
  • Scheduling
  • Financial Policy
  • Insurance
  • Surgery Instructions
  • Office Tour
  • Patient Satisfaction Survey
  • Notice of Privacy Practices & Patient Acknowledgement
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Patient Information and Registration

Before your appointment, you may pre-register with our office by filling out our secure online Patient Registration Form.  After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns, and we have taken every precaution to protect it.

You may pre-register and complete your medical history online to save time at our office, or fill-out a paper registration chart upon your arrival.

  1. Patient Information Patient Registration Form Download and PrintOnline Patient Registration Form
  2. Patient Registration Form PDF Download Print Version
  3. Or you may complete your patient registration and medical history on a paper chart upon your arrival

Your First Visit

Your initial appointment typically consists of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. This would typically be single extractions with local anesthesia. However, a preoperative consultation and physical examination is mandatory for patients undergoing type IV anesthesia during the surgery. Procedures requiring sedation and patients with a complex treatment plan and/or extensive medical history will require a consultation appointment and a subsequent appointment for the procedure. Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, etc.).

Please assist us by providing the following patient information at the time of your consultation:

  1. Your surgical referral slip and any x-rays if applicable
  2. A list of medications you are currently taking
  3. Names and phone numbers of your dentist and physician
  4. Dental and medical insurance information or cards

Minors: All patients under the age of 18 years of age must be accompanied by a parent or guardian during the consultation appointment.

X-Rays: If your dentist or physician has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. This will save time and permit us to help you as soon as possible. If additional x-rays are needed, they can be taken at our facility.

Scheduling

We try our best to stay on schedule to minimize your waiting. Our oral surgeons provide many types of dental services, and various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays. We appreciate your understanding and patience.

  • Please call our office with any questions or to schedule an appointment.
  • If you have pain or an emergency situation, every attempt will be made to see you that day.

Office Hours

Ventura Office 8:00 AM – 5:00 PM
Thousand Oaks Office 8:00 AM – 5:00 PM
Simi Valley Office 8:00 AM – 5:00 PM

Financial Policy

For your convenience, we accept Visa and MasterCard. We also accept CareCredit®, and can process an application for you if you do not already have an account. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered, unless other arrangements have been made in advance. If you have questions regarding your account, please contact us. Many times, a simple telephone call will clear up any misunderstandings.

  • Please remember you are fully responsible for all fees charged by this office, regardless of your insurance coverage.

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. We can make arrangements for a monthly payment plan, but that must be implemented prior to the actual procedure.

Insurance Information

At Pacific Oral & Maxillofacial Surgery, we make every effort to provide you with the finest care and the most convenient financial options. To accomplish this, we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well-informed and up-to-date.

  • Please call if you have any questions or concerns regarding your initial visit.
  • Please bring your insurance information with you to the consultation so that we can expedite reimbursement.

Surgery Instructions

At Pacific Oral Surgery, we will provide you with oral surgery instructions for preoperative and postoperative care for the specific oral & maxillofacial surgery performed. Carefully following our instructions based on the type of surgery performed will allow the best chance of a quick recovery and most optimal postoperative oral surgery results.

HIPAA Notice of Privacy Practices Notice of Privacy Practices & Patient Acknowledgement

Please read this Notice of Privacy Practices that tells you about the ways we may use and disclose your medical information. This Notice applies to the practice of Pacific Oral Surgery, including its professionals, employees, and contractors.

Welcome To Pacific Oral Surgery

Find Oral Surgeons in Ventura, Thousand Oaks & Simi Valley

Our Team at Pacific Oral SurgeryWelcome To Pacific Oral Surgery

Our team of board certified oral surgeons at Pacific Oral Surgery would like to welcome you to our offices in Ventura, Thousand Oaks and Simi Valley. Our qualified professionals are dedicated to providing top of the line services through personable, warm, and consistent patient care...Our Mission

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Ventura Office

Located on Telephone Road

Thousand Oaks Office

Located in the Los Robles Prof Park

Simi Valley Office

Located on First Street

Pacific Oral Surgery

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