New Patient Forms

We’ll need the information on the forms below prior to getting started. Please download the form, complete it and bring it to your first visit. If you are not able to complete these forms prior to your first visit, please arrive 10 minutes before your scheduled appointment.

Download All Forms

Download .zip File

Patient Registration

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Dental History

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Medical History

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Financial Policy

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Insurance Policy

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Privacy Policy

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HIPAA Compliance

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General and Implant Dentistry
Joshua Wieland DMD
150 NE 3rd Avenue
Canby, OR 97013

Phone: 503-266-2629

Office Hours:
Monday: 8:00 am to 4:30 pm
Tuesday: 8:00 am to 4:30 pm
Wednesday: 8:00 to 4:30 pm
Thursday: 8:00 to 4:30 pm
Friday: By appointment only
Schedule Your Appointment ›
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