Patient FormsThe form links below are for your convenience. They give you the opportunity to read our policies and notices in the comfort of your home. Informational forms can be completed in advance, so bring them with you to your first appointment. If you have any questions, please contact Tanya at 503-646-3169. Click on the form name to download a copy.Please fill out these forms and bring them with you to your first appointment. Thanks! >> Patient Information FormThis form details your patient history.>> Dental History FormThis form details your dental history.>> Medical History FormThis form details your medical history.>> Financial Policy FormThis form shares our financial policies with you.>> Privacy Notice FormRead this to understand important information about your privacy.>> Privacy Acknowledgement FormThis form acknowledges your receipt of the Privacy Notice form.Additional Forms>> Authorization to Disclose Medical Records FormThis form allows you to designate who your medical records may be disclosed to. Fill it out and bring it to your first appointment. Thanks! |
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