Patient Forms

For your convenience, we offer patient forms you can fill out for your child in advance. These convenient online forms will fast-track your way into your appointment with Dr. Julia Richman and help you feel more at ease during your time with us! For more information on our services, call Dino Kid’s Dentistry today at 253-220-7345 and request your appointment with our dentist in Covington, Washington.

Online Forms
New Patient Form

Existing Patient Update

Nitrous Oxide Consent Form

Downloadable Forms

HIPAA NOTICE OF PRIVACY PRACTICES

PATIENT REGISTRATION

HEALTH HISTORY

ACKNOWLEDGEMENT OF PRIVACY PRACTICES

Appt Cancellation Policy

Dental Insurance and Financial Policy

Teledentistry Consent