New Patient Forms

The following forms are provided to our patients online for download. Please print and complete the forms and bring them to your appointment.

If you have questions about any of the paperwork, please give us a call at (425) 771-2022 and our staff will be happy to help you.

•	New Patient Forms
•	HIPAA—Statement of Privacy Practices

We are your dental home for comprehensive care in a nurturing environment.
Call or click to make an appointment.

Request your appointment

Building relationships through trust and quality care.

Ariel Raigrodski, DMD, MS, FACP
Heidi Johnson, DDS
On-call evenings and weekends.

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19020 33rd Ave W Suite 200
Lynnwood, WA 98036

Call (425) 771-2022