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Patient Registration Forms

CLIENT REGISTRATION FORMS:

Please Download, print, and then fill out the appropriate forms. Then bring them with you to your appointment.

Online Patient Forms

Adult Registration Forms (age 18+)

Minor Registration Forms (17 and under)

Location

Our Location

3205 NE 78th St # 11 Vancouver, WA 98665

Hours of Operation

Our Regular Schedule

Monday:

9:00 am-6:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

9:00 am-6:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Featured Articles

  • Educational Videos

    Take a few minutes to watch our educational videos and learn more about different dental treatments and procedures. Video topics include general & cosmetic dentistry, Implants, oral health and hygiene, orthodontics and preventative dentistry. ...

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  • Periodontal (Gum) Disease

    While you may think that some loss of teeth is inevitable with aging, it is actually possible for all of your teeth to last a lifetime. One of the ways you can achieve this goal is to avoid periodontal disease (“peri” – around; “odont” – tooth), which is caused by bacteria that attack the ...

    Read More

  • Invisalign for Adults

    When you hear the word “orthodontics,” what comes to mind? Probably a young teenager whose teeth are covered by a latticework of metal. There are indeed many orthodontic patients who fit that description. However, there now exists an increasingly popular alternative to traditional metal braces: Invisalign® ...

    Read More
Testimonials

Straight from our patients!

  • "I called Lighthouse with a dental emergency and was seen by the dentist within 2 hours of the call. After X-ray, a treatment plan was discussed with me and immediately executed. I want to thank them for there quick action and professional manner. I will recommend Lighthouse to anyone who asks."
    Rick B.
  • "I love these guys!!!!"
    JAMES M.
  • "Dr. Erika and staff are fantastic! All are pleasant and efficient at what they do. We’ve been going to Lighthouse Dental for many years and will continue to do so. Thank you for the great service!"
    PATTI H.
  • "Great Dentist!! Great staff!! Great atmosphere!!"
    JIM S.
  • "It was my first visit. I will be staying with Dr.Takanami’s practice. The doctor gave me so much good information and advice. She did not rush through my appointment taking time to answer all my questions . She is very personable,"
    PATSY W.

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