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Lee Fong Dentistry
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SuperMouth
Lee Fong Dentistry
Services
Team
Calendar
Forms
Patient Resources
Contact
SuperMouth
Services
Team
Calendar
Forms
Patient Resources
Contact
SuperMouth

Forms

English

  • Patient Information Form

    Health History Form

    Patient Information and Health History Form (packet)

    COVID-19 Screening Form

    HIPPA Consent Form

    COVID-19 Safety Procedure

  • Toothache/Oral Pain Questionnaire (Billingual)

    Informed Consent for X-Rays

    Exam Form for Trauma Patients

  • General Information and Office Policy for Orthodontic Patients

    AAGO TMD Pain and Sleep Form

    Retainer Information

    Retention Consent Form

中文

  • Chinese Patient Information Form

    健康記錄

    新冠病毒期間的安全措施和常規護理

Other

  • Bệnh Sử (Vietnamese)

    COVID-19 Formulario de Cribado (Espanol)

Lee Fong Dentistry

345 9th Street, Suite 304

Oakland, CA 94607

(510) 272-0967

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