Patient Information

New Patients

Complete Your Forms Before Your First Visit

Save time at check-in by printing and filling out your new patient forms at home. Please bring the completed, signed forms with you to your appointment.

1. Download & Print

Download the forms below and print them at home.

2. Fill Out & Sign

Complete and sign the Patient Information, Health History, Root Canal Consent, and Privacy Acknowledgement forms. Keep the Notice of Privacy Practices for your records.

3. Bring Them With You

Bring the completed forms to your first appointment, along with the items listed below.

Download All New Patient Forms (PDF)

Includes all 5 forms below (6 pages). Or download them one at a time:

Patient Information Health History Root Canal Informed Consent Privacy Practices Acknowledgement Notice of Privacy Practices (your copy to keep)

Can’t print the forms? No problem — just arrive a little early to your appointment and our front desk will give you the forms to fill out at the office.

For your privacy, please don’t email completed forms — they include personal and insurance information. Bring them with you instead.

Your First Visit

What to Bring

Your completed, signed new patient forms
A photo ID
Your dental insurance card (if you have one)
Your referral slip and any X-rays from your dentist (if you have them)
A list of your current medications

What to Expect

Your Visit, Step by Step

Most root canal treatment is typically completed in just one visit. You’ll check in with our front desk, meet with Dr. Osmond to review your imaging and options, and leave with clear aftercare instructions — and your dentist receives a report the same day.

Questions before your appointment? Call us at (541) 776-7640.

Financing & Insurance

Insurance & Payment

We work with most dental insurance plans, offer flexible financing, and are happy to help you understand your options before treatment.

Premier Provider

Moda & Delta Dental

We are a premier provider with Moda and all Delta Dental plans, except federal plans.

Check your plan on Moda Find Care →

Accepted

All Other Dental Insurance

We accept all other dental insurance plans and will help you work with your insurance company.

Not Accepted

OHP & Jackson Care Connect

We are unable to accept the Oregon Health Plan (OHP) or Jackson Care Connect.

Flexible Financing Options

We offer financing through Cherry and CareCredit so you can get the care you need now and pay over time. Ask our front desk for details.

Cherry

Flexible payment plans that let you split the cost of treatment into smaller payments. Applying takes just a few minutes and does not affect your credit score.

Download the Cherry brochure (PDF) →Apply with Cherry

CareCredit

A health care credit card you can use to pay for treatment over time.

Apply with CareCredit

Financing is subject to approval by Cherry or CareCredit. Terms vary.

Good to know: Payment is due in full at the time of treatment. We’ll help you obtain insurance reimbursement, and your portion is an estimate that may be higher or lower depending on your plan. If you’d like an exact amount, we can submit a pre-authorization to your insurance (this typically takes 3–6 weeks). Questions about your coverage? Call us at (541) 776-7640.