James P. Walker, DDS, PC

Tualatin Endodontics ®                    503-885-1899

Specialist in Endodontics: microscopic non-surgical and surgical endodontics. Portland Oregon


You can download the Heath history and Dental history forms by clicking on the link buttons.
We can also fax or mail these forms to you.

Dental History
Patient History

Notice of Privacy Practices

Please Do Not take any pain medications for 24 hours prior to your examination appointment.

Call us if you have any questions.

Please assist us by providing the following information at the start of or prior to your appointment:

  • Your endodontic referral slip.
  • A list of your medications you are presently taking.
  • A completed Patient History Form.
  • A completed Dental History Form.
  • If you have dental insurance, please provide us with your insurance information 24 hours prior to your appointment. This will assure that your claim forms are properly submitted.

For non-emergency patients, your initial appointment will consist of a complete endodontic examination with a comprehensive explanation of your diagnosis and treatment options. This will allow me to evaluate the requirements of your needs and to provide you with accurate information about your treatment options.  

Online Form Package
Requires Adobe Acrobat DC
Acrobat Fillable Form Package:
If you have Adobe Acrobat, you can download the file and save the forms to your desktop.
Complete the forms, print, and bring with you.