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Patient Forms


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Forms and Instructions

We know your time is valuable, that’s why we put our new patient forms online so you can fill them out before stepping foot in the office.

Below you will find download for our New Patient Form. We custom tailor every treatment plan for each patient, so please contact us to find what course of treatment is best for you.

NOTE: All documents are in Adobe PDF format. In order to view this documents you must have a compatible program installed. You can find the latest version of Adobe Reader HERE.

•  All New Patient Forms
For all new patients, please download, print, and complete the above forms and bring them with you to your first visit.

Serving Salem Keizer Community since 1987

We provide dental services for the entire family from children to older adults. Our entire team of caring Doctors, hygienists and support staff pride ourselves on a high level of patient care.

Using the latest in modern dental technology our services range from sealants to complex implant surgery. Our goal is a comfortable experience for our patients with beautiful results.


Smile more :-) Call today

(971) 600-0211


Located in the heart of the beautiful Willamette Valley.

Convenient hours
Monday–Friday
7am–5pm

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3380 Astoria Way NE
Salem, OR 97305

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