Online Patient Registration

You may pre-register with one of our offices below by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. If you are experiencing TMJ problems, we ask that you fill in the TMJ section of the form at our office as well. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Which office would you like to preregister for?

• Olympia Office
• Centralia Office
• DuPont Office