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HIPPA Notice Form

This form is for patient information only and does not need to be printed unless the patient would like a hard copy. It describes our office HIPPA policy.

DOWNLOAD HIPPA NOTICE FORM
Adult
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Child
Registration

HIPPA
Acknowledgement

HIPPA
Notice Form

Insurance
Authorization Form

Medical
History

Financial and
Insurance Information

Oral
Hygiene Tips

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About Us

At My Forever Smile, we make straight teeth and beautiful smiles affordable and we do it efficiently to save you time! We use an effective method that corrects dental issues. A beautiful smile is within your reach.

  • Home
  • The Smart Choice
  • A Smile Revolution
  • Find a Provider
  • About Us
  • Become a Provider

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