Patient Forms

If you are a patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Patients should fill out and mail back, fax or scan the forms back ahead of their appointment. Patients faxing their forms can send them to 503-517-0113.  Thank you and please call our office if you have any questions at all.

Dental and Patient Forms

Medical History Form

Acknowledgement of Receipt of Notice of Privacy Practices

Consent from Patient to Release Dental Records

Privacy Form

Patient Advisory and Acknowledgment 

Appointment protocol 

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