Patient Forms
For your convenience, we have our patient forms available for download here.
Please print them and bring the completed forms with you to your new patient appointment.
Please print them and bring the completed forms with you to your new patient appointment.
Family Information
(One Per Family)
New Patient Medical History
(One Per Patient)
Statement of Privacy Policies
(For Your Review)
Dental Referral Form
Tongue Tie Referral Form
Please fax your referrals to:
425-212-1812
425-212-1812
Mukilteo
4420 106th St. SW
Mukilteo, WA 98275
T: (425) 290-5500
E: mukilteo@stellarkids.com
Everett
111 SE Everett Mall Way, Ste. D
Everett, WA 98208
T: (425) 212-1810
E: everett@stellarkids.com
Mill Creek
13209 44th Ave SE, Ste. 101
Mill Creek, WA 98012
T: (425) 381-4990
E: millcreek@stellarkids.com
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