To help keep our patients safe and healthy during the COVID-19 pandemic, Hymas Family Dental will be available for you Emergency Dental Needs.
Call our office if you are in pain or have an infection that needs medical attention right away. Dr Hymas is here to keep you out of the Emergency Room.
Hymas Family Dental | Patient Registration | Dentist in Spokane Valley, WA
509-922-1360Request an Appointment

420 N Evergreen Rd # 400, Spokane Valley, WA 99216

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Patient Registration

Please fill out all the information to the best of your knowledge. All answers will be kept confidential. If you have any questions, please ask us, and we'll be happy to assist you.
Whom may we thank for referring you?
 
Patient is Policy Holder Responsible Party
 

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Responsible Party is also a Policy Holder for Patient
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Patient Information

Sex: Male Female
Marital Status: Married Single Divorced Separated Widowed
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I would like appointment reminders via: E-mail Text
Emplyment Status: Full Time Part Time Retired
Student Status: Full Time Part Time
 

Primary Insurance Information

Relationship to Insured: Self Spouse Child Other
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Secondary Insurance Information

Relationship to Insured Self Spouse Child Other
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