206-487-7800 • 1515 N. 200TH ST., SHORELINE, WA 98133

Online Patient Forms

New Patient Forms

Please fill out the New Patient Forms prior to your appointment to save time at check-in!
Adult New Patient Form Child New Patient Form
Health Credit Assessment Consent Form

Health History Update Form

If you are a returning patient, please fill out this health history update form prior to your appointment.
Update Health History Form

You May Also Print These Forms If You Prefer

For those who prefer to fill out our patient forms by hand, here are our printable patient forms.

Print Adult Dental Health History Form Print Child Dental Health History Form
Print Patient Registration Form
Print Financial Policies Form

No dental insurance, no problem! With our Quality Dental Plan you can get the dental care you need at an affordable price.

© Eric Yao, DDS, MAGD, LLSR

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