New Patient Form

We have created a New Patient Form that can be printed and completed prior to your visit to the Tacoma Denture Clinic for your convenience. However, due to new federal regulations, you must follow these steps:

Step #1 - Click on Notice of Privacy Practices to open the .pdf file containing the Privacy Practices. Then print and read the pages.

Step #2 - Click on Notice of Privacy Practices Patient Acknowledgement to open the .pdf file containing the Patient Acknowledgement. Then print, complete, and sign the page and return it to our office.

Step #3 - Click on New Patient Form to open the .pdf file containing the New Patient Form. Then print, complete, and sign the page and return it to our office.

Please note: If you do not have Adobe Acrobat Reader currently installed on your computer system, please click on the following link and download and install the free program from Adobe.

Download Adobe Acrobat Reader

3712 South Cedar Street ~ Tacoma, Washington 98409
Phone: (253) 475-8570 ~ Toll-Free: (800) 404-8570
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