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Welcome to Southwest Orthodontic AssociatesMEDICAL HISTORYDENTAL HISTORYHome Phone # : () Cell Phone # : () Email Address: Do / did you have any of the following habits? Do you have / have you experienced
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Start by opening the welcome to southwest orthodontic form.
02
Fill out your personal information such as your name, address, and contact information.
03
Next, provide your insurance details if applicable.
04
In the following sections, indicate any specific concerns or issues you have regarding your orthodontic treatment.
05
If you have previously undergone orthodontic treatment, provide details of your previous treatment history.
06
Complete any additional sections or questions as requested on the form.
07
Review your answers to ensure all information is accurate and complete.
08
Once you have reviewed your answers, sign and date the form.
09
Submit the form to the southwest orthodontic office either in person, by mail, or by fax.
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If necessary, make a copy of the completed form for your records.

Who needs welcome to southwest orthodontic?

01
Anyone who is a new patient at southwest orthodontic needs to fill out the welcome form. This includes individuals of all ages who are seeking orthodontic treatment for the first time or transferring from another orthodontic provider.
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Welcome to southwest orthodontic is a form that patients fill out when visiting a southwest orthodontic clinic.
Patients who are visiting a southwest orthodontic clinic are required to fill out the welcome form.
Patients can fill out the welcome form by providing their personal information, medical history, and reason for their visit.
The purpose of the welcome form is to gather necessary information about the patient to ensure they receive appropriate care.
Information such as the patient's name, contact details, medical history, and insurance information must be reported on the welcome form.
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