Patient Registration

Welcome to West Seattle Endodontics!

Please call us at West Seattle Endodontics Phone Number 206-937-1010 to schedule your appointment. 

Before coming to your appointment, please print and complete the first 5 forms, to expedite your visit. Please bring your completed forms with you. 

  1. Patient Information
  2. Patient Medical History
  3. Privacy Policy
  4. Financial Agreement
  5. Root Canal Consent or Root Canal Surgery Consent

Additional forms for those patients requiring Nitrous Gas, Oral Sedation (complete forms 1-3) or CBCT Scan: 

  1. Oral Sedation Consent
  2. Nitrous Gas Consent Form
  3. Sedation Questionnaire
  4. CBCT Scan Consent

All appointments begin with the opportunity to address your questions and discuss your possible treatment and options. We strive to make you feel comfortable and welcome while providing the best in endodontic care.

During the examination, we will determine your endodontic needs and outline the fees for our professional services. Payment is due at time of service, unless other arrangements have been made.

We will be in close contact with your general dentist in order to provide you with the best comprehensive endodontic care.

It is our pleasure to welcome you to our practice. We hope that your experience with us is one of comfort and relief. If you have any questions for us before your appointment, please do not hesitate to contact us!