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Patient Forms

Save time and register online!

At Stacy Kanda Dentistry, we make things as easy and convenient as possible. All of our patient forms, including registration, dental record requests and insurance verification, can be accessed online.

Family dentistry servicesAcknowledgement or receipt of notice OP PP

Patient Registration Part 1

Patient Registration Part 2

Dental Record Request Form

Insurance Verification

Our Practice Financial Policy

Statement of Privacy Practices

Stacy Kanda,

2335 Southwest 320th
Street Suite 1
Federal Way, WA 98023

Federal Way:

(253) 661-2222


(253) 272-5930

Stacy Kanda, D.D.S., P.S. Providing quality dental services in Federal Way, WA for more than 30 years!