Secure Area Patient Registration

By submitting your Patient Registration and Health History prior to your appointment will save you valuable time and will allow our staff to give you more efficient service upon your arrival.

Once you complete the form, this system will automatically notify our office. We will then retrieve your information from our site's secure data base.

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1130 SW Morrison St., Suite 450, Portland, OR 97205 USA
Dr. Leslie Robert Milfred Portland DDS (503) 227-4410 (503) 227-6007