Patient Forms for Las Vegas Dentist Dr. Mohtashami

Please click here to print the new patient form and bring it in with you. By filling out this form you hereby grant authority to the dentist in charge of the care of the patient whose name appears in this Health History Form, to administer such anesthetics,analgesics, nitrous oxide sedation and intravenous sedation; and to perform such operations as may be deemed necessary or advisable in the diagnosis and treatment of this patient. I have been informed of all possible complications of procedures, anesthetics/ drugs.

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