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Welcome to our office ! ORTHODONTIC ACQUAINTANCE FORM JET SON S. LEE, D.D.S., M.S.D. PATIENT IS NAME Date FirstMiddleLastDate of Birth Age Sex Whom may we thank for referring you? Responsible Party
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Start by gathering all the necessary information such as personal details, medical history, and insurance information.
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Begin filling out the patient information section, including the patient's name, date of birth, and contact details.
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Provide detailed information about the reason for the visit and any specific dental issues or concerns.
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Fill out the medical history section, including any known allergies, current medications, and past surgeries or medical conditions.
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If applicable, enter the insurance information, including the policy number, group number, and primary insurance holder's details.
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In the treatment plan section, outline the recommended procedures and their respective costs.
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Complete any additional sections required by the dental office, such as consent forms or HIPAA agreements.
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Double-check all the information provided to ensure accuracy and legibility.
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Sign and date the form, indicating your agreement to the terms and acknowledgment of the accuracy of the information.
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Submit the completed form to the dental office staff and make any necessary payment arrangements.

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Christopher Oviedo DDS MS refers to a dental professional, specifically a Doctor of Dental Surgery (DDS) with a Master of Science (MS) degree, indicating advanced education and specialization in dentistry.
Typically, dental professionals like Christopher Oviedo DDS MS would be required to file relevant documentation to maintain licensure, report income for tax purposes, or submit any specific forms mandated by an association or regulatory body in dentistry.
Filling out forms related to Christopher Oviedo DDS MS would generally involve providing personal and professional information, including educational background, practice details, and any required financial information as specified by the filing body.
The purpose of Christopher Oviedo DDS MS is to provide dental care and treatment to patients, as well as to engage in research and education in the field of dentistry.
Information that must be reported may include personal identification details, professional qualifications, tax information, and any continuing education credits or achievements in dentistry.
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