Our Office Patient Forms

Online Patient Registration

You can fill out our initial patient registration forms directly on our website by clicking the link below.

Online Patient Forms (New & Existing Patients)
If you're a new patient, this is all we need you to fill out.

Download & Print

Click on a form below to view and print.




1130 SW Morrison St., Suite 450, Portland, OR 97205 USA
Dr. Leslie Robert Milfred Portland DDS (503) 227-4410 (503) 227-6007 [email protected]