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Marie Durflinger, DDS & Rima Abifaker, DDS
(425) 208-0032
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Bella Dental Care in Bellevue, WA
Bella Dental Care
Bella Dental Care in Bellevue, WA
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Home › For Patients › New Patient Forms

New Patient Forms
Close up of patient hands filling out patient forms on a tablet devicePlease download all the forms for your visit and bring them with you to your New Patient or Returning Patient visit. If your dental insurance has recently changed, or if your contact information needs updated, please call our office at (425) 208-0032 prior to your scheduled appointment so we can update our system and your benefit information accordingly.

Click on a link below to download the PDF form:


New Patient Form
Acknowledgment of Privacy
Notice of Privacy Policy
Patient Agreement Form & Financial Policy
Dental History Form
Medical History Form


Office Hours


Mon-Fri: 8:00am - 5:00pm
Sat: Appointment Only

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New Patient Forms - Bella Dental Care in Bellevue, WA
Please download all the forms for your visit and bring them with you to your New Patient or Returning Patient visit.
Bella Dental Care, 1550 140th Avenue NE, Suite 110, Bellevue, WA 98005-4500 - (425) 208-0032 - bellasmiles.com - 6/20/2025 - Related Phrases: dentist Bellevue WA -