New patient forms
Patient information & medical history
We appreciate the confidence you place in us. This information helps us care for you safely, and it stays confidential.
Online forms are coming soon. For now, please arrive 15 minutes early for your first visit to complete these forms in the office, or call us at (253) 845-8817.
What we'll ask for
Patient information
- Name, date of birth and contact information
- Home address
- Employer or occupation
- Spouse or guardian, if applicable
Medical history
- Allergies
- Current medications
- Previous dental treatment
- Medical conditions and hospitalizations
Consent and emergency contact
- Consent for treatment
- Emergency contact name, phone and relationship
What to bring
- Photo ID
- Your dental insurance card
- A list of your current medications
Please let us know about any recent changes to your health, and don't hesitate to ask questions.