I understand that the above information is necessary to provide me with safe and efficient dental care. I have answered all questions to the best of my knowledge.

By checking this box, I consent to receive transactional messages related to the services I have requested. These messages may include appointment reminders, payment confirmations, and general notifications, among others. The frequency of messages may vary. Message and data rates may apply. Reply HELP for assistance or STOP to unsubscribe.

I consent to receive SMS notifications, alerts, and occasional marketing communications from the company. Message frequency may vary. Message and data rates may apply. Text HELP to for assistance. You can reply STOP to unsubscribe at any time.