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Mark S. Khan, D.D.S., Inc. Lolita Torrance Dental OfficeCONSENT FOR USE AND DISCLOSURE OF HEALTH INFORMATION SECTION A: PATIENT GIVING CONSENT Name: Address: Telephone: Email Patient #: Social Security

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Blood sugar level refers to the amount of glucose present in the bloodstream at a given time. It is an important measure in diagnosing and managing diabetes.

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Individuals who are diagnosed with diabetes or those who are monitoring their blood glucose levels as part of their healthcare plan are required to file or track their blood sugar levels.

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Information that must be reported includes the date and time of the measurement, the blood glucose level reading, the type of test used, and any accompanying notes on diet or medication.

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