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Updated: 4/15/10Wendel Family Dental Center Consent for Dental Treatment Patients NameDatePLEASE INITIAL EACH PARAGRAPH AFTER READING. IF YOU HAVE ANY QUESTIONS, PLEASE ASK YOUR DOCTOR BEFORE INITIALING.
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Updated 41510 refers to the revised version of form 41510.
Any individual or entity specified by the regulatory authority must file the updated 41510 form.
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