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Lehigh Valley Cosmetic Dentistry
Your Smile is in Safe Hands
25 S Broad Street, Suite 106, Nazareth, PA-18064
610-365-8300
Thank you for taking the time to complete Our forms online!
Forms
1. Patient Information
2. Medical History
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3. ADA Covid Screening Form
4. Adult Airway & Sleep Questionnaire
5. Insurance Information
6. Financial / Cancellation Policy
7. Acknowledgement of Private Practice & Consent
8. HIPAA Policy
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