253-630-3331
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27015 169th Place S.E., #201, Covington, WA 98042
Dr. Jeffrey Kashner
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Adult Treatment
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Retention
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Contact Us
Home
Office Info
Meet the Doctor
Our Staff
Office Policies
Financial
Map and Directions
Appointment Request
Office Tour
Review Us
Smile Rewards
Patient Contests
Our Videos
Patient Info
First Visit
FAQ
Common Problems
Orthodontic Emergencies
Oral Hygiene
Foods to Avoid
Smile Gallery
Related Links
Glossary
Treatment
Early Treatment
Adolescent Treatment
Adult Treatment
Types of Braces
Retention
Orthognathic Surgery
Patient Forms
Contact Us
Patient Forms
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ONLINE FORMS FOR ALL PATIENTS
Please complete the following forms below. When you click on the link it will open a secure, online form via an app called PDFiller. Follow the directions and fill out each form completely including signature & hit submit, thank you!
New Patients
For new patients with an exam please fill out the appropriate forms below (Health History and HIPPA) prior to your exam appointment with us. Please fill out at your convenience (ideally a few days or more before your appointment) unlike the above forms which need to be filled out no sooner than 1-2 days ahead of your appointmen
t.
New Patient Exam - ADULT:
https://pdf.ac/BHoGp
New Patient Exam: CHILD:
https://pdf.ac/saCYl
*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.