Dr. Kay

General Dentistry for the Family

Forms

New Patients - Please fill out #1 and #2

1) New Patient/Account - Registration Form #1

2) New Patient/Account - Medical Background Form #2 (additional information we need)

Existing Patients - Please fill out #3 to update your records and medical history

3) Existing Patients -- Update Information Form

4) Customer Satisfaction Survey - Please fill out survey to help us maintain a high quality of service

We are now a paperless office! You can now fill out your registration form online at home or in our office. Just fill out all form boxes, and click submit. This sends the form to our secure web server where we can import it into our state of the art software. Not to worry, your information is totally secure and private. (privacy policy)

Web address begins with https: ("s" for secure & encrypted), and the locked padlock at the bottom of the window confirms the site's increased security.

auto-transferring to first secure form in 30 seconds >>>>>

Results Password

To Contact Us:

PO BOX 1090
YELM WA 98597

Phone: 360-458-5606
E-mail: yelmdental@ywave.com