Online Patient Registration and Health History forms  are available to fill out in the comfort of your home. The information is automatically sent to our office…

No need to print!  

Please register online and fill out your health history forms in advance of your appointment.  If you did not receive a Welcome Letter via email, call our office to receive your unique Username and Password.

After logging in you will need to complete the following sections:

~Patient Registration

~Medical History

~Pain History

Please remember to click the Submit button at the bottom of each section to save your information. We ensure that this web site is completely secure and your information will remain confidential.

When you arrive for your appointment, we will request your digital signature for the Patient Registration, Privacy Policy and Financial Policy forms.

If you have any questions along the way, please contact our office immediately at 253-851-5544.

Online Registration


GIG HARBOR ENDODONTICS   5122 Olympic Dr. NW, Suite B-101 Gig Harbor, WA 98335 Phone: 253-851-5544

PORT ORCHARD ENDODONTICS  1730 Pottery Avenue, Suite 200 Port Orchard, WA 98366 Phone: 360-443-2424


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