Medical History Form

Although dental personnel primarily treat the area in and around your mouth, your mouth is a part of your entire body.
Health problems that you many have, or medication that you may be taking, could have an important interrelationship with the dentistry you will receive.
Thank you for answering the following questions!

 
 
 
 
 
 
 
 
 
 
 
 
             
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Implants Consulatation For Dallas TX Area

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Schedule Your Dental Implant Consultation

Don’t ignore a single missing tooth just because no one can see it.
For more information on single tooth implants, and to schedule your consultation, contact our Coppell office today at
(972) 315-2345.

We Are Serving Coppell TX and the Surrounding Areas
  • Carrollton
  • Colleyville
  • Farmers Branch
  • Flower Mound
  • Frisco
  • Grapevine
  • Hebron
  • Irving
  • Las Colinas
  • Lewisville
  • Plano
  • Southlake
  • Valley Ranch