Pine Lake Dental Care

Experience The Difference

  • (425) 392-2103
  • 22727 SE 29th Street
    Sammamish, WA 98075
patient forms

Patient Forms


Help us get to know you!

Please take a moment to download, print and fill out our patient information forms. Please bring the completed forms with you to your initial appointment. If you have any questions along the way, feel free to contact our practice.

We are as concerned with your overall health as we are with your oral health. Please bring a list of any medications that you are presently taking. Please alert the office if you require pre-medication (antibiotic prophylaxis) prior to dental cleanings for any pre-existing medical condition or recent joint replacement.

Adult Registration Forms

Child Registration Forms


If you're unable to open PDF files, you can get Adobe Reader® for free.


We look forward to meeting you at your first appointment.

Back to top