Salwan Adjaj DMD PC

Serving our patients with compassion, excellence, and value.
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PATIENT REGISTRATION AND HEALTH HISTORY FORMS


You may print and fill out the patient registration and health history form and the dental quisetionnare. Bring this paperwork with you when you come for your appointment. This will save you time when you come in to our office for your first visit.

 

Patient Registration and Health History Form.pdf

 

Patient Dental Questionairre Form.pdf

 

These Forms are in .PDF (Printable Document Format) format and you must have Acrobat Reader installed on your computer to view and print them. If you do not have Acrobat Reader, please click here to download a free copy.