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P 914 833-9058 F 914 833-4267 2364 Boston Post Road Larchmont NY 10538 info larchmontsmiles. com www. To comply with one of HIPAA s requirements we are giving you a copy of our Notice of Privacy Practices. How often do you have dental examinations 7. Have you ever used or are currently using topical fluoride. Yes No 8. What other dental aids do you use Waterpik toothpick etc. 9. Do you have any dental problems now. I consent to your disclosures of my information which you deem are necessary...
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