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Downloadable Patient Forms
Please download the appropriate forms for your visit and bring them with you to your New Patient or Returning Patient visit. If your dental insurance has recently changed, or if your contact information needs updated, please call our office prior to your scheduled appointment so we can update our system and your benefit information accordingly. Click on a link below to download the form:

>> Registration Form For All New Patients

>> Health History Form for Patients Ages 14+

>> Health History For for Patients Ages 1-13

>> What Adults can expect at their Appointments

>> What to expect at your Child's Appointments

>> Our Financial Policy

>> Notice of Privacy Practices

You will need Adobe Acrobat Reader to access our forms. Adobe Reader is a free, downloadable tool. Click on the image below to start your download.

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Interest Free Financing
We invite you to learn more about your financing options to complete the dentistry planned for you by your doctor. Our staff will meet with you after a diagnosis to review all treatment recommendations and any associated fees. Our goal is to work with you to plan your dental care to avoid uncomfortable emergencies.

is a personal line of credit for healthcare treatments and procedures for your entire family. It works like a credit card, and can be used for dental care, optometry, and other healthcare related services. Contact us for more information about our interest-free options for your treatment (OAC).

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Bagley Dental | | (509) 547-1631
4904 Convention Drive, Pasco, WA 99301



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