Requesting and Sending Dental Records

Supporting requests for patient records is very important to us. In order to help you in the most efficient way possible, please review the steps below.

For Sending Patient Records to Willamette Dental Group

In order to send charts and/or X-rays to Willamette Dental Group for a patient, please mail them to our records department at the address below or via secure email. Disclaimer: All new patient charts and/or X-rays sent to us will be kept on file for six months and then deleted if patient fails to schedule and have their first appointment with a Willamette Dental Group provider.

Step 1:

Please use the following form so that we may have the information required to facilitate the request in either option displayed in step 2.

Request to Transfer Records Form
Step 2:

Send the completed records transfer form to either option available to you below. We adhere to the Dental Practices Act Standard to process requests received. Electronic Requests – 5 days. Printed Requests- 10 business days.

Option 1: Secure Email Portal Request (Instructions)

The secure email portal is available for requests to be sent in an encrypted format to protect protected patient health information. Please use records@willamettedental.com as the delivery address using this secure method only.

Option 2: US Postal Mailing Address Request

Submit your completed form and payment via mail at the address below.

Willamette Dental Group
ATTN: Records Department
6950 NE Campus Way
Hillsboro, OR 97124


For Requesting Patient Records from Willamette Dental Group

To request a copy of your patient records from Willamette Dental Group, please follow the steps below.

Step 1:

Complete the form below to duplicate your protected health information.

Authorization to Duplicate Protected Health Information Form
Step 2:

Send the completed authorization form to duplicate protected health information to either option available to you below. We adhere to the Dental Practices Act Standard to process requests received. Electronic Requests – 5 days. Printed Requests- 10 business days.

Option 1: Secure Email Portal (Instructions)

The secure email portal is available for requests to be sent in an encrypted format to protect protected patient health information. Please use records@willamettedental.com as the delivery address using this secure method only.

Option 2: US Postal Mailing Address Request

Submit your completed form and payment via mail at the address below.

Willamette Dental Group
ATTN: Records Department
6950 NE Campus Way
Hillsboro, OR 97124

Option 3: FAX Request

Send us your completed form and payment via fax to: 503-952-2601

Option 4: In-Person Request

Visit any of our offices Monday – Friday 7am – 6pm to submit your completed form and payment.


If you have additional questions

Please email our Records Department (do not email sensitive information via this link).

These forms are available for your convenience. If you are uncertain about which form to print and use, please contact us. Our Records department is open Mon – Fri 8 a.m. – 5 p.m.