| home | meet the dentist | what we offer | newsletter sign up |
 |
||||
| map & hours | appointments | ask the dentist | professional referrals |
 |
|
|||||||||||||||||||||||
    
|
|
|||||||||||||||||||||||
|
The
following pages are Notice of Privacy Practices,
Patient Acknowledgment of Privacy Practices and a
Patient Consent Form. The Notice of Privacy
Practices is yours to keep. The
following 2 pages are to be completed with your
signature and date (minors must have signature of
parent or legal guardian). The Notice of Privacy Practices Acknowledgment and Patient Consent Forms MUST be returned to our office the day of your appointment. Thank you for your cooperation. Dr. Allgood and Team |
||||||||||||||||||||||||
|
||||||||||||||||||||||||
In Augusta Georgia and the surrounding
Martinez - Columbia County - Central Savannah River Area - Richmond County GA areas.
Home | Meet the Dentist | What We Offer | Newsletter | Map & Hours | Appointments | Ask the Dentist | Professional Referrals
Copyright 2004 Internet Dental Alliance, Inc.
Terms of Use