The links on this page open forms that you can either complete online, then print and submit to WDS, or print and complete by hand. Please note that you can't save changes to these forms, so if you are completing a form online please be sure you have time and the information necessary to complete the form entirely once you begin.

• Member Dentist Agreement Application - new member dentist
  The forms in this packet are designed for dentists who are currently not a member of Washington Dental Service and would like to apply for membership.
• Member Dentist Agreement Application - new/additional location, existing member dentist
  Existing member dentists who wish to apply at a new or additional location can use this condensed applicaiton packet.
• Interactive Claim Form
  A claim form that you can complete online, print and submit to Washington Dental Service. 
• Credentialing Profile 
  This form must be completed in its entirety before Credentialing - a requirement for Delta Dental Premier membership - can begin.
• Rescind Termination/Reinstate Membership
  Please complete this form if you wish to reinstate your network participation with WDS.
• Service Office Address change form 
  Submit this for to WDS as soon as possible when you are moving.
• Service Office termination form 
  WDS requires written notification when you close a service office
• Purchase of Practice form
  Complete and submit this form if you are purchasing a practice from another dentist.
• W-9 Information
  Includes the W-9 form which provides your Tax ID number and business name filed with the IRS, and the cover sheet required with the W-9 form.
• Tax ID Change notification form 
  Use this form to submit your Tax ID Number change.
• NPI Profile  
  This form provides WDS with required information regarding your NPI number(s).
• Direct Deposit Form  
  Use this form to sign up for direct deposit for claims payment.
• DeltaCare Optional Treatment Consent form
  This consent form is a resource for your office to use when offering optional treatment to your DeltaCare patients.

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