Printable Dental Clearance Form
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Prior To Surgery, It Is Important To.
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Download This Dental Clearance Form For Dentists To Get All The Important Details About Your Teeth And Health.
Web the patient has indicated the following medical conditions: Allison & associates 15 aviemore drive pinehurst, nc 28374. Dear primary dentist, we anticipate initiating orthodontic treatment for _______________________________________ in the near future. Dentist name (please print) patient signature.