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PATIENT INFORMATION

MEDICAL HISTORY

PRIVACY STATEMENT

ONLINE SURVEY

 

New Patients

At Shemen Dental Group, we are excited to be your new dental care provider.  To reduce your waiting time on your first appointment, we have provided these new patient forms on-line.  Simply click on the form below, fill it out and click the SUBMIT button.  Your information will be securely transferred to our office immediately.

All new patients are required to fill out this simple patient information form.

Although dental personnel primarily treat the area in and around your mouth, your mouth is a part of your entire body.  Health problems that you may have, or medication that you may be taking, could have an important interrelationship with the dentistry you will receive.

At Shemen Dental Group, we hold your personal information in strict confidentiality.

Please take a moment to complete our Online-Survey.

 

 

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