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Please complete each form entirely and bring to your first appointment.

Printable Health History Form

Printable Insurance Information Form 

Printable Notice & Acknowledgement of Privacy Practices

Printable Authorization for Release of Information

Printable Financial/Office Policies Form

 


Michael L. Danze DMD ~ Family Dentistry
10610 Independence Pointe Parkway ~ Matthews ~ North Carolina  ~ 28105 ~ 704-845-2477
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