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Harbor Square Dental
Edmonds, WA
425-778-7477
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  • About Us
    • Meet Dr. Serra
    • Meet Dr. Winter
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    • Contact Information / Office Map
    • Request an Appointment
  • Patient Reviews
  • Forms
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Forms

When you call our office to make an appointment, we will ask you to provide patient registration details such as name and address, insurance information, etc. You can save time by printing and filling in these forms yourself. After you’ve completed the new patient forms, simply bring them with you on the day of your visit. Alternately, you can also fax them to us at 425-341-9662 prior to your dental appointment if you prefer. If you have any problems downloading the forms , be sure to call our office and we will gladly send them by mail, or fax them to you.

Download All Forms
  • Financial Policy
  • Patient Registration
  • HIPAA
  • Dental History
  • Health History

NOTE: Our office observes HIPAA Federal regulations that protect your privacy. We will never release any information about you without your written consent.

CALL TO MAKE AN APPOINTMENT TODAY

Edmonds Office Phone Number 425-778-7477

Technical Note:

Our registration forms are PDF document files. You must have the current Adobe Acrobat Reader (FREE) installed on your machine to view & print the forms.

Forms

     

     

    Patient Reviews Request An Appointment Referral Program
     
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    HARBOR SQUARE DENTAL

    120 West Dayton, Suite C-2, Edmonds, WA 98020

    Tel: 425-778-7477

     

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