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Foothill Endodontics

Serving Southern Oregon & Northern California

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Patient Forms

The forms linked below are blank forms you can view, print and complete at home.

This will require you to have a printer.

The PDF files will pop open in a new browser window, click the links below to access.

Online WEB FORMS [ click here ] submit your information online via a secure portal! There are 4 pages you can complete in the comfort of your home without needing to print anything. Be sure to click SUBMIT when done so the information is sent to us securely. If you do not we will not receive it, your information is not stored online.

Blank New Patient Forms: [ New Patient ]

Consent to release dental records form: [ Consent to Release ]

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