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Patient's
Medical History (2 Pages)
Print
and fill out this form and bring with you to your first appointment.
This will expedite your initial process.
Medical History Update Form Authority For Treatment
A
1 Page Form for first time patients. Print and fill out this form
and bring with you to your first appointment. This will expedite
your initial process.
Policy Of Care And Payment
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and fill out this form and bring with you to your first appointment.
This will expedite your initial process.
Hippa Form
Notice of Privacy Practices (2 Pages)
This
form describes how health information about you may be used and
disclosed and how you can get access to this information. Please
review it carefully. The privacy of your health information is important
to us.
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must have Adobe Acrobat Reader to view these files.
Partners
in Dental Health - Drs. Dean Kent, Charles Laurence, Keenan Davis and Mathew Kent
317 Edwin Dr., Virginia Beach Va. 23462
(757) 499-2100 738 Bay View Blvd. Suite 3, Norfolk, Virginia 23503 (757) 588-1563