Thank you for choosing Sterling Dental Associates. We ask that all new patients please complete the following medical history form for our records. If you have any questions while completing the form, please contact our office at (555) 555-5555 between 9AM-5PM (PST).
Are you completing this form on behalf of the patient?
Sterling Dental Associates | San Diego, CA | www.sterlingdentalassoc.com | (555) 555-5555 | email@example.com