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Patient Acknowledgment of Receipt of Dental Materials Fact Sheet

I,                                                                                        , acknowledge that I have received from the dental office of Smile Makers Dental

 

Specialty Group a copy of the 

Patient Acknowledgment of Receipt of Notice of Privacy Policies

I,                                                                                        , acknowledge that I have received from the dental office of Smile Makers Dental

 

Specialty Group a copy of the Privacy Policies.

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