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Gambia Family Dentistry 2207 Evans Street, Suite B Greenville, NC 27834 (252) 3535225 Dental Records Release Authorization Date: Patient Name: DOB: Phone Number: Please send records to:Previous Dental
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Start by entering the patient's personal information, such as their name, date of birth, and contact information.
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Provide any necessary medical history, including previous dental treatments, allergies, and medications.
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Indicate the reason for the visit and any specific concerns or issues the patient may have.
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Complete the insurance information, if applicable, including the provider and policy details.
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Review and sign any necessary consent forms, such as for treatment or photography.
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Schedule any follow-up appointments or additional treatments, as recommended by the dentist.
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Make payment arrangements, either by using insurance coverage or providing payment details.
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Finally, confirm the appointment details and provide any additional instructions or information to the patient.

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Gamboa Family Dentistry is a dental practice that provides comprehensive dental care for families, focusing on preventive, restorative, and cosmetic dentistry.
Individuals seeking dental services at Gamboa Family Dentistry are typically required to complete necessary registration forms for new patients, insurance claims, and treatment consent.
To fill out forms for Gamboa Family Dentistry, patients should provide their personal information, dental history, insurance details, and any consent required for treatment.
The purpose of Gamboa Family Dentistry is to provide quality dental care aimed at maintaining oral health, preventing dental issues, and offering treatments to improve patients' dental aesthetics.
Patients must report personal identification details, medical and dental history, current medications, allergies, and insurance information when registering at Gamboa Family Dentistry.
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