Dental Patient Forms

Valley Dental Works wants to understand your health and needs. We respect your time and allow a preference in how you complete our paperwork.

  • The forms may be printed from below and then you may bring them to your first visit.
  • We are happy to mail a set to you.
  • If you prefer to complete them in the office, please allow a few extra minutes before your appointment to avoid feeling rushed.

If you would like your dental insurance to be billed, please bring your card as well.

Patient Information Form

Health History Form

Dental History Form

Notice of Privacy Practices

Acknowledgement and Receipt of Notice of Privacy Practices

How We Do Business

These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo below to download.

Request a Consultation

Fill in this simple form and our office staff will get back to you ASAP.

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Our Office Location

16144 SE Happy Valley Town Center Drive
Suite #206, Happy Valley, OR 97086

Maps & Directions

Request a
Consultation

Fill in this simple form and our office staff will get back to you ASAP.

captcha
I agree to the Terms of Use

Our Office
Location

16144 SE Happy Valley Town Center Drive
Suite #206, Happy Valley, OR 97086

Maps & Directions

Our Video
Library