Forms

New Patients

Please complete the following forms prior to your scheduled consultation, and of course let us know if you have any questions along the way!

• Welcome Letter

• Patient Information

• Patient Health History

• HIPAA Consent Form & Disclosure Authorization

• Cancellations & Late Arrival Policy

Dental Offices

We want to do our best for you and your patients. When sending patients our way, please help us make the most of their experience by downloading and completing the following form, then faxing it to our office at (503) 747-0027.

• Referral Form

Please also email the most up-to-date Full Mouth Xrays you have for the patient to our office at info@beavertonperiodontics.com so our doctors can review them prior to their new patient exam.