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 "New Patient Forms" prior to your scheduled appointment:

1. If you have not yet contacted our office to setup an appointment, please contact us at 503.287.0072 or info@havendentalpdx.com. You have to have a patient ID to utilize the patient portal. 

2. On your mobile phone, tablet, or computer browser; click the link below, "Haven Dental PDX - Patient Portal" and a new window will open for our Haven Dental Patient Portal.

2. Enter your phone number or email. You choose whether to receive a one-time code through your email or phone number. 

3. Create a password for your patient portal account. 

4. Complete required and optional forms. Thank you!

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!