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THIS PAGE WOULD BE YOUR COMPLETE REGISTATION FORM WHICH WOULD HAVE IMFORMATION SUCH AS: PATIENT NAME, AGE, SS#, ADDRESS, PHONE #, EMPLOYMENT, INSURANCE INFORMATION, AND HEALTH HISTORY. IN MOST CASES THE BEST WAY TO HANDLE THIS PAGE IS TO DIRECTLY COPY WHAT YOU HAVE ON YOUR NEW PATIENT FORM TO THIS PAGE. YOUR PATIENT WILL BE ABLE TO PRINT THE FORM OUT TO BRING WITH THEM TO THE APPOINTMENT, OR SEND TO YOU BY E-MAIL SO YOUR INSURANCE COORDINATOR CAN CONTACT THE INSURANCE COMPANY FOR DENTAL COVERAGE BEFORE THE SCHEDULED APPOINTMENT. |
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