PATIENT RESOURCES

Office Forms & Policies

Please take a moment to fill out the following forms completely. If you have any difficulties, do not hesitate to call either our Hillsboro (503) 642-1535, Beaverton (503) 644-4749 or Cedar Hills (971) 713-3899 office for assistance. Please bring a copy of your insurance card to your child's appointment, as well as any prior dental records.

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IMPORTANT: When filling up the forms, please click “Preview PDF” and click the download button at the top right of the page. Kindly send the completed forms to hi5dental@gmail.com

New Patient Registration

Medical & Dental History Form

Office Financial Policy

Privacy Practices Acknowledgment

Referral Form

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Insurance Information

If you have dental insurance we will help you determine the coverage you have available. In order to best assist you, it is important that you submit your dental and/or medical insurance information to us with your New Patient Paperwork a minimum of seven business days prior to your scheduled appointment. This allows us time to contact your insurance company and obtain a breakdown of the benefits you or your employer has purchased from the company.

Should you be diagnosed with treatment services, we will be able to provide you with a detailed plan which will give you an estimate of how much your insurance company may pay for each procedure, as well as the portion you will be expected to pay at the time of service.

Professional care is provided to you, our patient family, and not to an insurance company. The insurance company is responsible only to the patient as a benefit from the individual or employer plan purchase, and the patient is responsible to the doctor. We will assist you in every way we can in the filing of your dental or medical claim and handling of insurance questions from our office on your behalf.

Preferred Provider Insurance

We accept most dental insurance plans, and are contracted providers with the below plans.

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Logo of the Oregon Blue Cross Blue Shield and Moda Health
Logos of MetLife and Delta Dental.

Helpful Resources

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Great Smiles Start with A Positive First Experience.

We strive to answer all inquiries as soon as possible and look forward to assisting you with your dental needs.

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