Patient Forms

We're accepting new patients!

Download Patient Forms

Here at University Place Smiles, we are dedicated to providing you with the best and most affordable dental care. We always welcome new patients and would like to thank you for referring family and friends to our practice.

Below, you'll be able to download our patient form. Please fill out, print, and bring it on your next visit. It will save your time in our office.



Your initial appointment will consist of a consultation explaining your diagnosis and treatment options.

Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation if possible:

  • Your referral slip and any X-rays if applicable
  • A list of medications you are presently taking
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.