Kirkland Dentistry > Dental Services > Patient Information > New Patient Forms

New Patient Forms

From the first day you join our office, we will care for your dental needs.

As part of your first visit with us, you will fill out a comprehensive medical and dental history. This form is important because it helps us to determine the course of your treatment. We have to know about allergies, sensitivity to anesthetics, long-term medications, etc.


For your convenience you can download the New Patient Registration Forms and the HIPAA Privacy Form here. Please click on the links to download and print out these forms at home, where you can fill them out at your leisure and bring it with you to your first visit. 


If you are unable to complete these forms prior to your first visit,

please arrive 15 minutes early for your appointment.  



DOWNLOAD Patient Registration Form


DOWNLOAD Financial Policy

DOWNLOAD Authorization to Release Health Information