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New Patient Information

For your convenience, we have all your new patient forms available to fill out, and have ready to go before your appointment. Please bring all forms with you or email to us at smilesdoctorgomez@comcast.net.

 

New Patient Forms Listed Below:

New Patient Registration.pdf

Medical History.pdf

Practice Policies 1.pdf

Practice Policies 2.pdf

Consent for Service.pdf

Acknowledgement of Privacy.pdf

Patient Photograph Authorization .pdf