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Patient Forms

Patient Forms

Welcome to Brilliant Smiles Bellevue! To make your visit as pleasant and easy as possible, we ask that you download and print the following patient forms to prepare for your first visit. 


Health History Form

New Patient Registration

Financial Policy Form


Brilliant Smiles Bellevue
13033 Bel-Red Road, Suite 230
Bellevue, WA 98005
Phone: 425-454-1975

Office Hours

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