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COSMETIC EVALUATION FORM Welcome! So that we may provide you with the best possible care please complete the cosmetic evaluation form. All information is completely confidential. Patient Name Medical
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Fairfax Dentistry is a dental practice located in Fairfax.
Patients who receive dental services at Fairfax Dentistry may be required to provide their information for filing purposes.
Patients can fill out the necessary forms provided by Fairfax Dentistry either online or in person.
The purpose of Fairfax Dentistry's website is to provide information about their services, location, and to allow patients to schedule appointments.
Patients may need to report their personal information, insurance details, and medical history.
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