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COLORADO Center FOR IMPLANT & PROSTHETIC DENTISTRY Dr. James Marina DDS MS PC Dr. Kushal Drawn BDS Patient Referral Form Patient's Name: Date: Contact info: Address City: State: Contact no: Home:
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To fill out the Colorado Center for Implants form, follow these steps:
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Begin by providing your personal details, such as your name, address, and contact information.
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Next, provide information about your medical history, including any previous dental procedures or relevant health conditions.
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Specify the reason for seeking implant services and provide details about the specific implants you require.
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The Colorado Center for Implants is a specialized center that focuses on dental implant procedures.
Dentists and dental professionals who perform implant procedures are required to file with the Colorado Center for Implants.
The Colorado Center for Implants form can be filled out online or by submitting a paper form with the required information.
The purpose of the Colorado Center for Implants is to track and regulate the use of dental implants in the state for patient safety and quality control.
The Colorado Center for Implants form typically requires information such as patient details, implant type used, procedure date, and practitioner information.
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