Please fill out the following forms before your first appointment.
Intake Form
Financial Arrangements Form
Notice of Privacy Practices
Cancellation and Missed Appointment Policy
Thank you!
Intake Form
Financial Arrangements, Insurance Authorization and Billing Information
Notice of Privacy Practices
Cancellation and Missed Appointment Policy
Acknowledgment of Receipt
Denture Agreement of Acceptance
Immediate/Permanent Denture Agreement of Acceptance
The Denture Specialist
926 12th Street
Hood River, OR 97031
Hood River: (541) 386-2012 The Dalles: (541) 296-3310
[email protected]