Get Mid-America Dental Clinic Patient Registration 2019
Cessary. Please answer the following questions as accurately as possible. Do you have or have you ever had: Heart by-pass? Mitral valve Prolapse? Asthma? Sinus problems? Emphysema? Persistent cough? Pain in your jaw? Diabetes? Stroke? HIV or AIDS? Glaucoma? Anemia? Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No.
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