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Healthy Smiles for ME, Inc. Scan with your phone Please Complete this Consent Form if you would like your child to receive Preventive Dental Services provided by Independent Practice Dental Hygienists

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Healthy smiles for me is a program aimed at promoting dental health and providing preventative care for individuals.

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Information such as dental visits, treatments, prescribed medications, and any dental health concerns must be reported on healthy smiles for me.

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