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Pomona VALLEY ORAL & MAXILLOFACIAL SURGERY MEDICAL HISTORY FORM Name: Date of Birth:Date: Sex: M / Height:For the following questions, circle yes or no, whichever applies. Records only and will be
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What is pomona valley maxillofacial and?
Pomona Valley Maxillofacial and is a medical facility specializing in oral and maxillofacial surgery.
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Patients who have received treatment or surgery at Pomona Valley Maxillofacial and may be required to file necessary paperwork for insurance purposes.
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Patients can fill out the necessary paperwork either in person at the facility or online through a secure patient portal.
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The purpose of Pomona Valley Maxillofacial and is to provide specialized oral and maxillofacial surgical treatment to patients.
What information must be reported on pomona valley maxillofacial and?
Patients may need to report personal information, insurance details, medical history, and treatment received at the facility.
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