Smile Ballard Dr. Curalli & Dr. Allen
5350 Tallman Ave NW, #410, Seattle, WA
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Smile Ballard Dr. Curalli & Dr. Allen (Seattle, WA)
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1. Health History
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2. Insurance Info
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3. Authorization for Release of Dental Records
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4. Patient Info
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5. New Patient Questionnaire
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6. Communication
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7. Financial Form
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8. Cancellation Policy
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9. Acknowledgement of Receipt of Statement of Privacy Practices
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10. Statement of Privacy Practices
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