Tacoma Office: 253-537-5565

Vashon Island Office: 206-463-3313

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You are here: Home / Patient Forms

Patient Forms

Please prepare for your appointment by completing the appropriate forms. Download the form to your computer to complete at home. Then bring it with you to your appointment.

First Visit Form

New Patient Form

Removal Consent Forms

Braces Removal Consent Form
Phase I Braces Removal Consent Form

Sleep Apnea Consultation Forms

CPAP Affidavit Form
Sleep Intake Questionnaire

Information about Treatment

Your First Week in Braces
Preventing Problems with Your Braces
Flossing and Brushing with Braces
Retainer Care Guide
Molar to Molar Herbst Appliance Picture
Orthodontic Informed Consent

These documents are in PDF format. If you’re unable to read PDF files, you can download Acrobat Reader free from Adobe.

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Daryl Yorek DDS, MS
Daryl Yorek DDS, MS
5.0
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tiesha williams
tiesha williams
20:10 13 Aug 19
Wonderful people
Jenn Adrien
Jenn Adrien
21:20 02 Nov 18
Between being tough to schedule, having to deal with braces at work, and feeling like a doof, being an adult with braces is hard! But Dr. Yorek made it worthwhile. His staff got me in quickly when things didn't quite work out as intended, and called me back right away any time I had a question or challenge. Thanks to Dr. Yorek and his team for making sure that my smile is healthy and beautiful. And for any teens reading this: wear your retainers! I had braces as a teen and didn't wear my retainers after a couple of years. Paying for braces yourself has a way of making you a very compliant patient.
Jessica Griffiths
Jessica Griffiths
18:10 06 Jun 18
Dr. Yorek is the best hands down!
Charles Bishop
Charles Bishop
03:44 29 Mar 18
I seen Dr Yorek for my sleep apnea. I was fitted with an appliance to correct my jaw to help me sleep better and eliminate the use of my cpap machine. It works wonders! My wife and I sleep so much better now all thanks to Dr. Yorek. He is a great doctor and wonderful to talk to. The staff are polite, respectful and easy to talk to aswell.
Mustache Man
Mustache Man
07:14 10 Dec 17
Awesome place nice staff and net. Kid friendly. Amazing place to get braces. I suggest to go hear. And hi Dr. Yorek this is Megan's daughter
ariel davidson
ariel davidson
03:42 28 Oct 15
Loved how nice everyone was. I went to Dr. Yorek about 14 years ago when I needed braces and took my son to see him today. Same great service and information. Such an awesome office and orthodontist :)
Kevin Moore
Kevin Moore
22:06 13 Oct 15
What a joy to come to Dr Yorek's office! A very friendly staff and the best care possible for my daughter's teeth. We are very happy we made the choice to come here.
Jason Almont
Jason Almont
18:59 11 Aug 15
I've visited Dr. Yorek's office several times. My friends kids have all their orthodontic work done her and have been very happy with the experience. THEY HAVE AN OLD PLAYABLE NINTENTDO 64 RETAIL DISPLAY SETUP IN THEIR LOBBY!! Now that's a cool orthodontist.
Jennifer Bearss
Jennifer Bearss
02:40 05 Aug 15
Today was my son's initial consult. The entire staff was amazing! They are all very kind, helpful , and welcoming. They all wanted to make sure all our questions were answered. My son enjoyed his first experience at the orthodontist and I would recommend this office to anyone looking for orthodontics! An amazing first experience in a medical office!!!
Nicole Monton
Nicole Monton
21:45 04 Aug 15
Amazing experience...professional staff...would recommend Dr. York and his staff for any dentistry needs. My daughter teeth look beautiful.
Cindy Hitch
Cindy Hitch
22:50 18 May 15
Dr Yorek is an amazing orthodontist! Their care is great!
Brooke Carmichael
Brooke Carmichael
16:09 18 May 15
My daughter Stella loves coming to see Dr. Yorek and his staff. Everyone is so cheerful and upbeat. They are very understanding of the younger kids and explain things to them. I also love as a patent that Dr. Yorek uses the latest and greatest orthodontic appliances and care. It's just an amazing place!
Shelly Odman
Shelly Odman
18:17 05 May 15
I have just started my treatment with Dr. Yorek, and so far, I am pretty impressed. The staff and Dr. Yorek have made me feel welcome and encouraged about my treatment. I can't wait until I get my braces off and I get to see the end results. They bent over backwards to make braces a real possibility for me when no one else did. Great Job! Dr. Yorek and staff.
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Tacoma Office

Daryl Yorek, DDS, MS
12165 Pacific Avenue South, Suite B
Tacoma, WA 98444
253-537-5565

Vashon Island Office

Daryl Yorek, DDS, MS
9929 SW Bank Rd, Suite 101
Vashon Island, WA 98070
206-463-3313


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