For Providers Sending Patient Records to Willamette Dental Group

To send patient charts and X-rays to Willamette Dental Group, please follow these steps:

Step 1

Complete this form. To sign the form, please download and add an Esignature in Adobe Acrobat or print, sign, and scan the signed document to us.

Step 2

Submit the completed form to our Records Department via secure email, fax, OR US postal mail: 

Secure Email Portal

The secure email portal is available to send requests in an encrypted format to protect patient health information. Please use as the delivery address.


Please fax any patient records you are submitting to 503-952-2601.

US Postal Mailing Address

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

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.

We adhere to the Dental Practices Act Standard to process requests received. Estimated turnaround time is 5 business days for electronic requests and 10 business days for printed requests. We do not offer rush processing.