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Patient Forms

You may access the following forms to assist us with your care. If you use the online forms, please complete and submit the appropriate form via this website. If you are printing the form, please print and complete, and bring the form to your appointment.

Online Forms

Printable Form


Get Adobe ReaderThese forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo to download.

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

***For Apple/Mac Users: You must use Adobe Acrobat Reader to submit the forms. To do so, simply right click on the form and save form. Open form in Acrobat Reader, fill out the form and submit.

Smile By the Station Dentistry

  • Smile By the Station Dentistry - 7114 S. Martin Luther King Jr. Way, Suite 200, Seattle, WA 98118 Phone: 206-725-7176 Fax: 206-723-1656

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