Printable Patient Forms
The below patient forms can be printed and completed before your visit to Northwest Portland Dental. Please bring the completed forms with you during your appointment.
Patient Intake Form
Click here to access our patient intake form to download, print, or complete ahead of time.
Dental History Form
Click here to access our dental history form to download, print, or complete ahead of time.
Financial Agreement
Click here to access our financial agreement form to download, print, or complete ahead of time.
Medical History Form
Click here to access our medical history form to download, print, or complete ahead of time.
Acknowledgment of Privacy Practices
Click here to access our acknowledgment of privacy practices form to download, print, or complete ahead of time.
Records Release
Click here to access our records release form to download or print ahead of time.
Dentist Near You
Address:
2311 NW Northrup St.
Suite 101
Portland, OR 97210
Hours
Monday: 7:00 AM - 4:00 PM
Tuesday: 7:00 AM - 4:00 PM
Wednesday: 7:00 AM - 4:00 PM
Thursday: 8:00 AM - 2:00 PM
Friday: Closed
Saturday: Closed
Sunday: Closed
Excellence in Dental Care for the Entire Family
Contact Us Today for an Appointment
Don’t wait, schedule your appointment with our friendly dental team today and keep your smile healthy and bright.