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FORMS

Please download and complete the following forms prior to your visit at our practices in order to expedite your treatment experience.

Forms: News

Forms to complete ahead of your visit

Please click on the link to complete our medical history form, and then bring this form to your appointment

Please click on the link to read and sign our consent form, and then bring this form to your appointment

Please click on the link to read and sign our patient financial responsibility form, and then bring this form to your appointment

Please click on the link to read and sign our HIPAA release form, and then bring this form to your appointment

Please click on the link to read and sign our privacy policy form, and then bring this form to your appointment

Michigan Endodontics

(586)-573-6860

11300 East Thirteen Mile Road

Warren, Michigan 48093

Blue Water Endodontics

(810)-985-7300

Holland Dental Centre

1982 Holland Avenue

Port Huron, Michigan 48060

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