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HEALTHY SMILES OF DELAWARE, PA Patient Registration Patient Information: First Name:___ Last Name:___ M.I.___ Address:___ City, State, Zip Code:___ Home Phone:(___)___Work:(___)___Ext:___ Cell Phone:(___)___
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How to fill out healthy smiles of delaware
How to fill out healthy smiles of delaware
01
Visit the Healthy Smiles of Delaware website.
02
Click on the 'Patient Forms' tab.
03
Download the 'New Patient Registration Form'.
04
Fill out the form with your personal information, insurance details, and medical history.
05
Make sure to sign and date the form.
06
Bring the completed form with you to your first appointment at Healthy Smiles of Delaware.
Who needs healthy smiles of delaware?
01
Individuals looking for dental care in Delaware.
02
Patients in need of regular dental check-ups and treatments.
03
Those seeking a dentist that accepts various insurance plans.
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What is healthy smiles of delaware?
Healthy Smiles of Delaware is a program that aims to improve dental health and provide access to dental care for residents of Delaware.
Who is required to file healthy smiles of delaware?
Dentists and dental clinics in Delaware are required to file Healthy Smiles of Delaware.
How to fill out healthy smiles of delaware?
To fill out Healthy Smiles of Delaware, dentists and dental clinics need to provide information about the dental services provided, number of patients seen, and other relevant data.
What is the purpose of healthy smiles of delaware?
The purpose of Healthy Smiles of Delaware is to track and improve dental health outcomes, increase access to dental care, and monitor dental service utilization in the state.
What information must be reported on healthy smiles of delaware?
Information reported on Healthy Smiles of Delaware includes number of patients seen, type of dental services provided, and demographics of patients.
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