Online Patient Forms

We welcome new patients at East Portland Dentistry, home of your East Portland dentist of choice! We want to make your first visit to our office as convenient as possible. We’ve included our new patient forms here so that you can fill them out online or download them and fill them out at your convenience prior to your visit. 


Full Online Forms

Complete Online Patient Forms

Note: These complete forms include all four Adult forms back-to-back: Registration, Adult Dental History, Adult Medical History, and Privacy Notice Acknowledgement. Please complete all pages.


Single Online Forms


PDF Versions Of Our Forms

These forms are Adobe Acrobat PDF documents. This format allows you to make high-quality printouts using your printer. To download them, you’ll need the Acrobat Reader plug-in for your web browser. It’s available for free and installs quickly. Follow the link below if you need it.*

Please fill out all pages for each new patient.

*If your computer doesn’t already have Adobe Reader installed, you will first need to install the Adobe Reader in order to view and download the PDF file. You can then print these forms on your desktop printer.

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