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PATIENT REGISTRATION & HEALTH HISTORY FORM
PLEASE CLICK BELOW TO DOWNLOAD THE PDF FORM, AND FILL OUT.
UPLOAD PATIENT REGISTRATION & HEALTH HISTORY
When you come in for your dental appointment
At Sunrise Dental, we want you to be as comfortable as possible.
When you come in for your dental appointment, please have the following:
Current Driver’s License or Picture ID
Current Dental Insurance card
Previous dental records and health care records, if available
List of current medications
If x-rays have been taken within the last year, please bring a copy from your previous dental provider to your first appointment. The doctor cannot properly diagnose your current condition without current x-rays and some insurance companies do not allow more than one set per year. Also please provide dates of previous surgeries/medical diagnosis.
Visiting the dentist can be scary! At Sunrise Dental, we want you to be as comfortable as possible. When you visit your dentist at Sunrise Dental, whether as a new patient or an existing patient, you can expect the best patient care! We strive to deliver excellence in everything we do, but always remember that you are the ultimate decision-maker on all dental procedures being performed.
Paperwork
If you did not fill out the documents online, you will spend the first 10-15 minutes filling out paperwork. This paperwork allows us to have all of the vital information to properly identify each patient, bill any insurance programs you may have and evaluate your medical health history prior to discussing your current dental needs.
X-rays
In order for the dentist to properly diagnose interproximal caries (cavities between the teeth), bone density, and other oral cavity anatomies a series of x-rays will be required. These typically take about 15 minutes. The dentist will review these x-rays prior to any inspection or work on the patient.
Evaluation
Please verbally notify the dentist if you are pregnant or have another health condition that you feel they should be aware of, regardless of whether you have documented it on your paperwork.
It will be necessary for the dentist to evaluate the following for each patient: Review your medical history, and ask any questions that may have an affect your current oral health.
Oral Cancer Screening – this is a visual inspection of the oral cavity, including the lips, tongue, teeth, and throat
Bone and Gingiva (gum) Health – color, trauma, indications or periodontal disease, and swelling or bleeding
Oral Hygiene – how well you have been taking care of the oral cavity
Caries and Cavity Evaluation – looking for areas of decay on each tooth
Intraoral photos will be taken to show the patients pictures of their oral cavity as well as documenting any findings for insurance purposes.
Treatment Plan
The Dentist will explain any findings from the evaluation and develop a personalized treatment plan based on dental necessity. All decisions on care are made by the patient, however, the dentist will discuss any options and the priorities of each necessary treatment. The treatment coordinator will further explain your treatment plan including any financial obligation that the patient may have after your insurance has paid their portion.
Cleaning & Education
Depending on your current oral condition, the dentist may be able to clean your teeth the same day. If there is a diagnosis that takes priority over cleaning, additional appointments may be required. If the dentist was able to clean your teeth, the dentist or Dental Assistant will polish & floss your teeth. Some patients may also receive a fluoride treatment or sealant. The Dentist and or Dental Assistant will explain how to maintain proper oral hygiene and what changes you may need to make in your daily routine to maintain a healthy mouth.
Completion
Upon completion of your appointment, the Dental Assistant will walk you to the front desk to schedule your next appointment. Typically in six months unless there is a need for you to come back at an earlier date. Your 6-month Routine Check-up & Cleaning appointment will be scheduled and you will be provided a card with this date and time.
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We welcome your feedback. If you encounter any accessibility barriers or otherwise have difficulty using our website due your disability, please contact our office or reach out to our website provider at 844-487-8399 for assistance.
MODIFICATION OF THESE TERMS OF USE This Practice reserves the right to change the terms, conditions, and notices under which this Practice Web Site is offered, including but not limited to the charges associated with the use of this Practice Web Site.
LINKS TO THIRD PARTY SITES This Practice Web Site may contain links to other Web Sites (“Linked Sites”). The Linked Sites are not under the control of this Practice and this Practice is not responsible for the contents of any Linked Site, including without limitation any link contained in a Linked Site, or any changes or updates to a Linked Site. This Practice is not responsible for webcasting or any other form of transmission received from any Linked Site. This Practice is providing these links to you only as a convenience, and the inclusion of any link does not imply endorsement by this Practice of the site or any association with its operators.
NO UNLAWFUL OR PROHIBITED USE As a condition of your use of this Practice Web Site, you warrant to this Practice that you will not use this Practice Web Site for any purpose that is unlawful or prohibited by these terms, conditions, and notices. You may not use this Practice Web Site in any manner which could damage, disable, overburden, or impair this Practice Web Site or interfere with any other party’s use and enjoyment of this Practice Web Site. You may not obtain or attempt to obtain any materials or information through any means not intentionally made available or provided for through this Practice Web Sites.
USE OF COMMUNICATION SERVICES This Practice Web Site may contain bulletin board services, chat areas, news groups, forums, communities, personal web pages, calendars, and/or other message or communication facilities designed to enable you to communicate with the public at large or with a group (collectively, “Communication Services”), you agree to use the Communication Services only to post, send and receive messages and material that are proper and related to the particular Communication Service. By way of example, and not as a limitation, you agree that when using a Communication Service, you will not:
Defame, abuse, harass, stalk, threaten or otherwise violate the legal rights (such as rights of privacy and publicity) of others. Publish, post, upload, distribute or disseminate any inappropriate, profane, defamatory, infringing, obscene, indecent or unlawful topic, name, material or information. Upload files that contain software or other material protected by intellectual property laws (or by rights of privacy of publicity) unless you own or control the rights thereto or have received all necessary consents. Upload files that contain viruses, corrupted files, or any other similar software or programs that may damage the operation of another’s computer. Advertise or offer to sell or buy any goods or services for any business purpose, unless such Communication Service specifically allows such messages. Conduct or forward surveys, contests, pyramid schemes or chain letters. Download any file posted by another user of a Communication Service that you know, or reasonably should know, cannot be legally distributed in such manner. Falsify or delete any author attributions, legal or other proper notices or proprietary designations or labels of the origin or source of software or other material contained in a file that is uploaded. Restrict or inhibit any other user from using and enjoying the Communication Services. Violate any code of conduct or other guidelines which may be applicable for any particular Communication Service. Harvest or otherwise collect information about others, including e-mail addresses, without their consent. Violate any applicable laws or regulations. This Practice has no obligation to monitor the Communication Services. However, this Practice reserves the right to review materials posted to a Communication Service and to remove any materials in its sole discretion. This Practice reserves the right to terminate your access to any or all of the Communication Services at any time without notice for any reason whatsoever.
Materials uploaded to a Communication Service may be subject to posted limitations on usage, reproduction and/or dissemination. You are responsible for adhering to such limitations if you download the materials.
LIABILITY DISCLAIMER THE INFORMATION, SOFTWARE, PRODUCTS, AND SERVICES INCLUDED IN OR AVAILABLE THROUGH THIS PRACTICE WEB SITE MAY INCLUDE INACCURACIES OR TYPOGRAPHICAL ERRORS. CHANGES ARE PERIODICALLY ADDED TO THE INFORMATION HEREIN. THIS PRACTICE AND/OR ITS SUPPLIERS MAY MAKE IMPROVEMENTS AND/OR CHANGES IN THIS PRACTICE WEB SITE AT ANY TIME. ADVICE RECEIVED VIA THIS PRACTICE WEB SITE SHOULD NOT BE RELIED UPON FOR PERSONAL, MEDICAL, LEGAL OR FINANCIAL DECISIONS AND YOU SHOULD CONSULT AN APPROPRIATE PROFESSIONAL FOR SPECIFIC ADVICE TAILORED TO YOUR SITUATION.
THIS PRACTICE AND/OR ITS SUPPLIERS MAKE NO REPRESENTATIONS ABOUT THE SUITABILITY, RELIABILITY, AVAILABILITY, TIMELINESS, AND ACCURACY OF THE INFORMATION, SOFTWARE, PRODUCTS, SERVICES AND RELATED GRAPHICS CONTAINED ON This Practice WEB SITE FOR ANY PURPOSE. TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, ALL SUCH INFORMATION, SOFTWARE, PRODUCTS, SERVICES AND RELATED GRAPHICS ARE PROVIDED “AS IS” WITHOUT WARRANTY OR CONDITION OF ANY KIND. THIS PRACTICE AND/OR ITS SUPPLIERS HEREBY DISCLAIM ALL WARRANTIES AND CONDITIONS WITH REGARD TO THIS INFORMATION, SOFTWARE, PRODUCTS, SERVICES AND RELATED GRAPHICS, INCLUDING ALL IMPLIED WARRANTIES OR CONDITIONS OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT.
TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL THIS PRACTICE AND/OR ITS SUPPLIERS BE LIABLE FOR ANY DIRECT, INDIRECT, PUNITIVE, INCIDENTAL, SPECIAL, CONSEQUENTIAL DAMAGES OR ANY DAMAGES WHATSOEVER INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF USE, DATA OR PROFITS, ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE OR PERFORMANCE OF THIS PRACTICE WEB SITE, WITH THE DELAY OR INABILITY TO USE THIS PRACTICE WEB SITE OR RELATED SERVICES, THE PROVISION OF OR FAILURE TO PROVIDE SERVICES, OR FOR ANY INFORMATION, SOFTWARE, PRODUCTS, SERVICES AND RELATED GRAPHICS OBTAINED THROUGH THIS PRACTICE WEB SITE, OR OTHERWISE ARISING OUT OF THE USE OF THIS PRACTICE WEB SITE, WHETHER BASED ON CONTRACT, TORT, NEGLIGENCE, STRICT LIABILITY OR OTHERWISE, EVEN IF THIS PRACTICE OR ANY OF ITS SUPPLIERS HAS BEEN ADVISED OF THE POSSIBILITY OF DAMAGES. BECAUSE SOME STATES/JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR CONSEQUENTIAL OR INCIDENTAL DAMAGES, THE ABOVE LIMITATION MAY NOT APPLY TO YOU. IF YOU ARE DISSATISFIED WITH ANY PORTION OF THIS PRACTICE WEB SITE, OR WITH ANY OF THESE TERMS OF USE, YOUR SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USING THIS PRACTICE WEB SITE.
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Any rights not expressly granted herein are reserved.
NOTICES Please contact us by phone at 425-405-6230 or by mail at 3218 NE 12th Street, Suite B, Renton, WA 98056.
Clients Love
Google Testimonials
Love this dentist office, everyone have been friendly, professional and very thorough! So glad I discovered this office it’s the best care I have ever gotten! Many cleanliness practices in place. Thank you Dr Choi, Dr. Lee and Stephen!
Mark A Today was my first time visiting Sunrise Dental and I thought all of the staff was very friendly and kind. The installation is nice and clean, all the covid precautions in place. The doctor explained my procedure very well, he made sure I had all my questions answered.
Berenice RuizAccepted Insurance Providers
At Sunrise Dental of Renton, we are dedicated to our patients' dental health. We accept most PPO insurances to make sure that all of our patients are covered.
If your insurance is not listed or if you have any questions, please call our office to see how we can partner with you.
No words needed!! This place was just great! It was my first appointment here but everything was satisfy (easy to find location, clean/sanitized, friendly dr. and staffs) And most import part was best dental exprience I've ever had. I am highly recommended.
Lindsey Kim GOOGLE REVIEW