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Harvey Dentistry, SML, PC 12925 Booker T. Washington Hwy, Suite 202 Hardy, Virginia 24101 5403280098(p) SML blueridgedentalgroup. Compartment Information (Confidential)Date Name DOB SS# Address City
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How to fill out harvey dentistry sml pc

01
Begin by gathering all necessary information and documents, such as personal identification, insurance information, and any relevant medical history.
02
Visit the Harvey Dentistry website or office to obtain a copy of the SML PC (Submission of Medical and Legal Protection Consent) form.
03
Read through the form carefully to understand what information is required and how it should be filled out.
04
Start by entering your personal details, such as your full name, date of birth, and contact information.
05
Provide your insurance information, including the name of your insurance provider, policy number, and any relevant contact details.
06
If applicable, disclose any pre-existing medical conditions or allergies that may affect your dental treatment.
07
Review the form once completed to ensure all information is accurate and legible.
08
Sign and date the form to indicate your consent and understanding of the provided information.
09
Make a copy of the filled-out form for your records, if necessary.
10
Submit the completed SML PC form to the Harvey Dentistry office by mail, email, or in person, as instructed.

Who needs harvey dentistry sml pc?

01
Anyone who plans to receive dental treatment at Harvey Dentistry may need to fill out the SML PC form.
02
This includes both new and existing patients who are undergoing or will undergo various dental procedures, such as cleanings, fillings, extractions, or cosmetic treatments.
03
The SML PC form is designed to protect the dental practice and ensure that patients understand the risks and potential complications associated with their treatment.
04
Therefore, it is essential for individuals seeking dental care at Harvey Dentistry to complete this form accurately and thoroughly.
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