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Patient Advisory and Screening Form Dear Patient: Thank you for coming to our office today for routine dental evaluation and/or treatment. Please be advised of the following: While our office complies

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How to fill out mariah shojaei dmd

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To fill out Mariah Shojaei, DMD, follow these steps:

02

- Start by entering your personal information such as your name, date of birth, and contact information.

03

- Next, provide details about your dental history, including any previous treatments or procedures.

04

- Fill in the medical history section, including any known allergies, chronic conditions, or medications you are currently taking.

05

- Provide information about your dental insurance, if applicable.

06

- Indicate the reason for your visit or any specific concerns you have regarding your dental health.

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- Finally, sign and date the form to confirm that all the provided information is accurate and complete.

Who needs mariah shojaei dmd?

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Mariah Shojaei, DMD, is needed by individuals who require dental care or treatment. This may include anyone experiencing dental issues such as tooth decay, gum disease, or oral infections. Additionally, individuals who require routine dental check-ups, cleanings, or cosmetic procedures may seek the services of Mariah Shojaei, DMD, for their dental needs.

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What is mariah shojaei dmd?

Mariah Shojaei DMD is a dental clinic run by Dr. Mariah Shojaei.

Who is required to file mariah shojaei dmd?

Patients who receive dental services from Mariah Shojaei DMD are required to file their information with the clinic.

How to fill out mariah shojaei dmd?

Patients can fill out Mariah Shojaei DMD forms either online through the clinic's website or in person at the clinic.

What is the purpose of mariah shojaei dmd?

The purpose of Mariah Shojaei DMD is to collect and maintain accurate dental records for patients.

What information must be reported on mariah shojaei dmd?

Patients need to report their personal information, medical history, and any treatments received at Mariah Shojaei DMD.

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