Your first visit to Lukin Family Dentistry establishes a vital foundation for our relationship with you! During the first visit, we make sure to obtain important background information , like your medical history , and give you time to get to know your doctor . You'll find all the practical information you need, such as a forms, insurance, payment policies and more. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

To fulfill this mission, we are committed to:

  • Listening to those we are privileged to serve.
  • Earn the trust and respect of patients, profession and community.
  • Exceed your expectations.
  • Ensure a creative, challenging, and compassionate professional environment.
  • Strive for continuous improvement at all levels.

Thank you for being a new patient at our office!
To expedite your first visit please follow the instructions to complete the form below.

New Patient Interactive Form (pdf)

DSHS Notice of Privacy Policy (pdf)

Other Forms:
(if applicable)

Medical Clearance Form

In order to view or print these forms, you will need Adobe Acrobat Reader installed.
Click here to download it. Adobe Acrobat Reader

New Patient Form Instructions

  1. Download the PDF form above, and SAVE it to your computer.*

    * Please note that even though you may be able to fill out the PDF within a web browser we don’t recommend it unless you are proficient in how it works. We ask that you first save the PDF onto your computer , and then open that saved file using Adobe Reader. This will help ensure that your answers are saved properly.

  2. Open the document with Adobe Reader and complete the form to the best of your ability.
  3. To RESAVE the completed form, choose File > Save As, and rename the file. For easy access save it on your desktop and email the form back to us at [email protected] .

We are happy to work with any traditional insurance plans or PPO. We will work to help you maximize your benefits. We will gladly file with your insurance company.

We accept all major credit cards, checks, and also cash. Interest free financing is also available.


CareCredit is here to help you pay for treatments and procedures your insurance doesn’t cover. We offer No Interest* financing or low minimum monthly payment options so you can get what you want, when you want it.  For more information or to apply online, visit