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CHILD PATIENT ENDODONTIC HISTORY Page 1 of 2 Family Dentistry 3223 4th Street SW Mason City, Iowa 50401 641.424.6461 DR. TIMOTHY WEBER & DR. MICHAEL OTTO PATIENT INFORMATION 24 South Hawkeye Nora
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How to fill out family dentistry child patient:
01
Have all the necessary information ready, such as the child's name, date of birth, and contact details.
02
Fill out the medical history section accurately, including any allergies, chronic conditions, or medications the child is currently taking.
03
Provide details of the child's previous dental visits, if any, including any treatments or procedures done.
04
Mention any specific concerns or issues the child may have, such as dental anxiety or behavioral challenges.
05
Specify any dental insurance information or payment preferences.
06
Sign and date the form, indicating that all the information provided is accurate.
Who needs family dentistry child patient:
01
Children who require regular dental check-ups and treatments to maintain good oral health.
02
Parents or guardians seeking comprehensive dental care for their children, including preventive measures and treatments.
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Families looking for a dental provider who can address the unique needs and concerns of children, ensuring a positive and comfortable experience for the child during dental visits.
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