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Patient Medical Information

This page contains information about our Patient Information and Medical History forms. If you have any questions about these forms, please contact Valley Smiles in Renton, Washington. After you have reviewed our information, you can print copies to fill out and bring with you on your first visit, or you can mail it ahead of time. Please take time to view the personal, medical, and dental history information that you will be asked to provide. Please call us at 425-271-1727 if you have any questions.


Please read and know that you will be asked to provide this information before any services will be rendered.

Filling this information out ahead of time makes your visit with our dentist, Dr. Christine Chen, more efficient and allows our team to focus on you and your dental needs.

Click on the link below:

***If you are having difficulty accessing or understanding any form pertaining to Valley Smiles, please contact our office. We will be happy to assist with your specific needs.

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