Patient Forms

We are always accepting new patients and understand that your time is valuable and therefore offer several ways to make an appointment from calling us to emailing us.

WE understand that coming to the dentist may not be high on your list of priorities and therefore we do everything we can to make your visits comfortable, relaxing and friendly.

  • Tea and coffee are available in the reception room for patients and family members or caretakers.

  • We provide a variety of 'G' rated children's movies that can be viewed in the reception room.

  • Those patients coming in for long procedures, we invite their ride to do some shopping at Northgate Mall or grab a cup of coffee- we’ll call you when the procedure is done and they are ready to go.

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initial paperwork -  child:

For children under 18 years of age please have your parent and/or guardian download and fill-out these questionnaires to bring with you to your scheduled appointment. 

Initial paper work - Child

Authorization Form

Initial X-Ray Consultation

Parent's 'Private Eye' Home Sheet


Initial paperwork - adult:

For Adults over 18 years of age please download and fill-out these questionnaires to bring with you to your scheduled appointment. 

Initial paper work - Adult

Authorization Form

Initial X-Ray Consultation

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insurance information

Dr. Chae works with most insurance plans.

Call our office at 206-257-1648 to see if we can get you approved with your dental insurance company.

We also accept credit cards, cash, checks, and are happy to help set up payment plans on an individual basis.

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