J. Darrel Jensen, DDS
Creating Beautiful Smiles
Call: (206) 284-0566

Patient Forms

If you are a new patient to our office, the attached files contain our new patient forms. Printing them, filling them out and bringing them with you will help expedite your visit with us.  Thank you and please call our office if you have any questions.

Patient Forms (please print and complete before your visit with us) 

Basic Information


Medical History


 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.


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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Office Location

  • Seattle
  • 812 5th Avenue North Suite 4
  • Seattle, Washington
  • 98109
  • Map & Directions
  • Call: (206) 284-0566