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Crystal Springs Dental Patient Confidentiality Questionnaire Patient Name: ***Should the need arise, I authorize Crystal Springs Dental to share with the following people (i.e. spouse, family member,
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Crystal Springs Dental is a dental clinic located in Crystal Springs.
All patients who receive dental services at Crystal Springs Dental are required to file.
Patients can fill out the necessary forms in person at the clinic or online through the clinic's website.
The purpose of Crystal Springs Dental is to provide quality dental care to patients in the Crystal Springs area.
Patients must report their personal information, insurance information, and details of the dental services they received.
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