If You Were Born On February 29th 2004 How Old Would You Be

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If You Were Born On February 29th 2004 How Old Would You Be

If You Were Born On February 29th 2004 How Old Would You Be

DENTAL CLEARANCE FORM PLEASE HAVE YOUR DENTIST COMPLETE ALL SECTIONS OF THIS FORM AND FAX IT TO 216 445 9608 If you have had your teeth removed wear Patient: DOB: ______. Dear Dr. ,. Our mutual patient,. , is scheduled for dental treatment. Treatment may include: _____ Cleaning (simple or deep).

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Medical clearance for Dental Treatment

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