Due to the COVID 19 virus our schedule has changed. Please contact us at 503-777-1332

6227 SE Powell Blvd, Portland Ore. (503) 777-1332

Jonathan Roxas DDSJonathan Roxas DDSJonathan Roxas DDSJonathan Roxas DDS

Jonathan Roxas DDSJonathan Roxas DDSJonathan Roxas DDSJonathan Roxas DDS

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Patient Forms

You can download forms needed to be filled out for your new patient appointment. If you haven't been in for awhile you may print out or if you have a PDF reader that is capable of filling in the forms, update your file by clicking below. 

Patient information (pdf)Download
Medical History (pdf)Download
Oral Cancer Screening Consent form (pdf)Download
Financial Agreement pdf (pdf)Download
Consent for Treatment (pdf)Download
Dental Questionnaire (NEW)1 (pdf)Download

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