Patient Registration

Secure New Patient Forms in Pullman

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data are one of our primary concerns and we have taken every precaution to protect it.

Please note that our office requires New Patient Registration at least 48 hours prior to your appointment. 

Patient Registration

Note to Patient: Upon filling out your first name, last name, email and at least one phone number field (a valid home or cell phone) a button will appear in the upper right corner titled “Save and Exit“. This button allows you to save and exit your form to complete it at a later date. The system will send a registration email to the email provided on the form, so that you may set up a login to go back and finalize your registration form online.

Imagine Smiling With the Radiance of a Beautiful Smile!

Call Us Now to Find a Smile You'll Be Happy to Show Off!

Call us: 509-332-4711