If you prefer a non-web fillable PDF, please fill out the forms below and bring them with you to your scheduled appointment, or email them to info@havendentalpdx.com.
Haven Dental PDX - Patient Information, Dental & Medical History, and Release of Records
Haven Dental PDX - Notice of Privacy Practices
Should you be unable to fill out these forms online, we can provide you with a paper copy when you arrive for your visit. If this is the case, please arrive 15 minutes early to give yourself ample time to complete these.
We look forward to seeing you smile!
Patient Forms
Prior to your first visit at our office we will need some additional information from you. To ensure you get the most out of your allocated appointment time, please complete the New Patient Registration Forms prior to your scheduled appointment.
If you have not yet contacted our office to setup an appointment, please contact us at 503.287.0072 or info@havendentalpdx.com.
You must have a patient ID to utilize the patient portal.
If you have not yet contacted our office to setup an appointment, please contact us at 503.287.0072 or info@havendentalpdx.com.
You must have a patient ID to utilize the patient portal.
If you have not yet contacted our office to setup an appointment, please contact us at 503.287.0072 or info@havendentalpdx.com.
You must have a patient ID to utilize the patient portal.
If you prefer a non-web fillable PDF, please fill out the forms below and bring them with you to your scheduled appointment, or email them to info@havendentalpdx.com.
Haven Dental PDX - Patient Information, Dental & Medical History, and Release of Records
Haven Dental PDX - Notice of Privacy Practices
Should you be unable to fill out these forms online, we can provide you with a paper copy when you arrive for your visit. If this is the case, please arrive 15 minutes early to give yourself ample time to complete these.
We look forward to seeing you smile!