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OSU Dental Clinics Patient Referral Information Please fill out all fields. Any missing information can delay the referral process. Date: Patient Name: Date of Birth: Male Female Preferred Phone:
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Visit the OHSU Dental Clinics website
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What is ohsu dental clinics?
OHSU Dental Clinics are dental care facilities affiliated with Oregon Health & Science University.
Who is required to file ohsu dental clinics?
The individuals or entities providing dental services through OHSU Dental Clinics are required to file.
How to fill out ohsu dental clinics?
OHSU Dental Clinics forms can be filled out online or in person at the clinics.
What is the purpose of ohsu dental clinics?
The purpose of OHSU Dental Clinics is to provide high-quality dental care to patients and to train future dental professionals.
What information must be reported on ohsu dental clinics?
Information such as patient demographics, services provided, and billing details must be reported on OHSU Dental Clinics forms.
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