We are re-opening! Please read our COVID-19 Statement to learn more about how we are keeping our patients safe!

Patient Forms


 

Patient

Forms



It is easy to make an appointment for your initial examination and dental treatments. Call 425-746-6090 to speak with a staff member and you can download the New Patient Form by clicking below.


Our New Patient Form also includes Office Policies and Privacy Practices.

NEW PATIENT FORM

PRIVACY ACKNOWLEDGEMENT



For referring offices, below is our Patient Referral Slip

PATIENT REFERRAL SLIP

Location

EZ Dental Clinic
1130 140th Ave. NE, Suite 100B
Bellevue, WA 98005
Phone: 425-746-6090
Fax: 425-747-9856

Office Hours

Get in touch

425-746-6090