Call: (425) 252-0111 | Visit: 3230 Colby Ave Suite 3, Everett, Wa. 98201 | Book an Appointment ▸

Patient Forms

Help us get to know you!

Please take a moment and fill out our patient information forms. If you have any questions along the way, feel free to contact our practice. You can email them back to us at info@milesneffdds.com or you can print them off and bring them to your first appointment.

  1. Adult Health History

  2. Child's Health History

  3. Patient Registration

  4. HIPPA Form

  5. Notice of Privacy Form

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.

NOTE:  Filling in the form, printing it and bringing it with you is the recommended procedure.