Patient Forms

Call (360) 523-9294

If you are a new patient to our office, below are the new patient forms that will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.


Child Dental Medical History

Adult Medical History

Dental History

Acknowledgement of Privacy Practices

Privacy Practices

Request for Release of Dental Records

This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

Smile With Confidence

As dental professionals it is our priority to provide quality dental care you can trust.



View More