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Home
About Us
Meet Our Staff
Best Cosmetic Dentist in Moscow, ID
Invisalign Provider in Moscow, ID
Same-Day Crowns Near Me
Dental Implants
TOUR
PATIENT FORMS
Paperwork For Patients
Dental Benefits Plan
Contact Us
MY ACCOUNT
Patient Information
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*
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*
Date
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ID#
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If Other:
Consent for Treatment
I hereby grant permission for dental work to be performed on myself or the named patient below (if patient is a minor)
and will assume all responsibilities connected with such treatment.
Patient Name
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Relation to Patient
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Signature
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(Signature of Parent/Guardian if patient is a minor)
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Home
About Us
Meet Our Staff
Best Cosmetic Dentist in Moscow, ID
Invisalign Provider in Moscow, ID
Same-Day Crowns Near Me
Dental Implants
TOUR
PATIENT FORMS
Paperwork For Patients
Dental Benefits Plan
Contact Us
MY ACCOUNT