Patient Forms

We are excited to get to know you!

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 "Patient Registration Forms" prior to your scheduled appointment:

1. On your mobile phone, tablet, or computer browser; click the link below, "Haven Dental PDX - Patient Registration Forms" and a new window will open prompting you to fill in your information.

2. Once completed with the first form, select "Next" in the upper left hand corner of the window and you will be directed to the next form in the series. 

3. After completing all 4 forms, select "Submit" and your information will automatically send securely to our office you will be redirected to this page and you are good to go!

4. If you have not yet contacted our office to setup an appointment, please contact us at 503.287.0072 or info@havendentalpdx.com.


Haven Dental PDX - Patient Registration Forms


If you prefer a non-web fillable PDF please fill out the forms below and bring them with you to your scheduled appointment, or e-mail them to info@havendentalpdx.com. Thank you. 

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. Thank you!

We look forward to seeing you smile!


Haven Dental PDX
Creating Beautiful Healthy Smiles

Portland Dentists, Drs. Alex Dahm and May Chang are dental professionals dedicated to General, Family & Cosmetic Dentistry such as Dental Exams, Cleanings, X-rays, Fluoride, Dental Makeovers, Teeth Whitening, Veneers, Crowns, & more. Please come and visit Portland, OR Dentists at Haven Dental PDX.

2023

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2023

Site Map


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