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Form C SUPPLEMENT TO APPLICATION SUPPLEMENTAL QUESTIONNAIRE FOR DENTAL RELATED FIELDS 1. In the last 5 years, have you administered general anesthesia? Yes No If YES, where is the anesthesia administered?
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Form C Supplement is to provide additional information or clarification to Form C.
Entities or individuals who have filed Form C and need to provide supplementary information.
Form C Supplement should be filled out with the requested additional information or clarification in the designated sections.
The purpose of Form C Supplement is to provide additional details or explanations that were not covered in the original Form C.
Form C Supplement must report specific details or clarifications that are relevant to the information provided in Form C.
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