Robert S. Gurmankin, DMD
 

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Forms & Documents
     Health History Form

Health History.pdf 179KB

     Patient Information Form

Patient Info.doc 25 KB

     HIPAA Notice

The Following PDF file contains a Notice of Privacy Practices, which describes how health information about you may be used and disclosed, and how you can get access to this information.  The file is also available in Word format.

HIPAA Notice of Privacy Practices.pdf 21.2 KB

HIPAA Notice of Privacy Practices.doc 65.5 KB
 

Disclaimer
All advice provided on this web site is in the nature of general advice only. The advice may not be applicable to your particular circumstances. You are therefore advised to seek detailed advice from a qualified dentist prior to embarking on any course of action. We can not accept liability for any treatment undertaken on the basis of this web site.

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