Call: (503) 305-2525
Request an Appointment
Woodburn Modern Dental Logo

  • Home

  • Announcements

  • About Us

  • Services

    • Cosmetic Dentistry
    • Endodontic Treatment
    • General Dentistry
    • Oral Surgery
    • Pediatric Dentistry
    • Periodontal Care
    • Preventative Dentistry
    • Prosthodontics

  • Our Team

  • Contact Us

    • Appointment Request

  • Forms

    • English Forms
    • Spanish Forms

  • Specials

  • Patient Portal

  • Blog

  • More

    Use tab to navigate through the menu items.
    Forms

    This page contains forms used by the Dentist and staff. Please download, print, fill out and bring the required forms with you for your appointment.

    New Patient Forms
    Adult Forms

    1. Health History Form

    2. General Consent

    3. HIPAA Consent

    4. Covid-19 Screening

    Child Forms

    1. Child Health History Form

    2. General Consent

    3. HIPAA Consent

    4. Covid-19 Screening

    Treatment Consent Forms

    1. Extraction Consent

    2. Periodontal Consent

    3. Root Canal Consent

    All Other Forms

    1. Covid-19 Screening

    2. HIPAA Consent

    3. Release Authorization

    • Facebook

    © 2021 by Woodburn Modern Dental