Welcome to Clearwater Dental

New Patient Forms

Submit your forms direclty online to save time at the office.

To save time from filling out paperwork in the office, you can fill out and submit the online form directly below, or you can print out the PDF forms on your own to fill out and bring into the office (or mail to: Clearwater Dental, 5000 W Clearwater Ave, Kennewick, WA 99336).

New Patient Questionaire (PDF)
Tell us a little about yourself so we can best serve you and your unique needs.
Medical History (PDF)
This provides us awareness of any diseases and medications that might impact with your dental treatment.
Acknowledgement of Notice of Privacy Practices (PDF)
​​We require acknowledgement of our Notice of Privacy Practices (PDF) so you know your privacy is protected.

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