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Remember!
Continuous Care Maintains Good Oral Health. Make Your Annual Appointment
Today!
Special
Smiles, Ltd.
100 E. Lehigh Ave., Centennial Two Philadelphia, PA 19125
215-707-0575
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Forms
For
your convenience you may
download and print the
required forms and
instructions:
New Patient:
Intake Form
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Pre-Op:
Pre-Operative Instructions for Dental
Care Under General Anesthesia
What You Should Know
About Pre-Sedation and
General Anesthesia
Pre-Operative Physical
Examination For for
Dental Care
Under General Anesthesia
Instructions for
Care Following Oral
Surgical Procedures
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Consent & HIPAA
Forms:
Consent for Pre-Sedation
and General Anesthesia
Consent for Comprehensive Dental Treatment
under General
Anesthesia
Information Regarding
Extractions
Notice of Privacy Practices (HIPAA)
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