Patient Forms

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Insurance Update

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From your first day as part of our dental family, we want you to feel welcome and cared for. Part of our new patient experience includes a comprehensive medical and dental health history review. This helps us understand your concerns and goals, and allows us to treat you to the very best of our ability.

For your convenience, we offer several patient forms in PDF (Acrobat Reader) format, which you may download from the right; once downloaded, you may print and fill-out the required forms in the comfort of your home, and bring them with you at your first appointment, or fax beforehand if appropriate.

Adult Patient Information

Child Patient Information

Office Policies

Statement Of Privacy Practices

HIPPA Acknowledgement Of Receipt Of Statement Of Privacy Practices

COVID-19 Screening Form

Northgate Smiles COVID-19 Protocol

Call (206)-362-1516 For An Appointment