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First Visit
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Meet Us
Surgical Instructions
Before Anesthesia
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Patient Information
First Visit
New Patient Registration
HIPAA Privacy
Finance & Insurance
Procedures
Meet Us
Surgical Instructions
Before Anesthesia
For Doctors
Contact Us
Payment
Attn: Doctors, PA's, and/or Office Staff
Complete the patient referral information (below)
Doctor's Name
*
*
Indicates required field
Patient's Name
*
Your Name
*
Your Email
*
Procedure/Instructions
*
Remove the following teeth
*
Medical History
*
Upload File
*
Max file size: 20MB
What else should we know?
*
If the patient desires I.V. sedation or general anesthesia, he/she should be accompanied by a responsible adult and not eat or drink six hours prior to the appointment. Minors must be accompanied by a parent or guardian.
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Jeffrey N. Hamlin, DMD, PC
1850 Whites Road
Kalamazoo, MI 49008
269.385.2101
Office/Emergency
[email protected]
Patient Information
First Visit
New Patient Registration
HIPAA Privacy
Finance & Insurance
Procedures
Meet Us
Surgical Instructions
Before Anesthesia
For Doctors
Contact Us
Payment
