CLINICAL FORMS PATIENT INFORMATION & REGISTRATION FORMS Child Adult (366-8423) Front Back ADULT AND CHILD REGISTRATION FORMS * Comprehensive, full-color forms warmly welcome patients * 2-sided forms are updated regularly to provide the caregiver a thorough understanding of the patient's dental and medical history * Features complete insurance information with a signature for assignment benefits * Allergy section covers drugs, latex, and metals * 81⁄2"W x 11"H Forms100 per Pkg 44.99 142 www.henryscheindental.com (366-0642) Front Back Full-Color & 2-Sided!http://www.henryschein.com/redirect.aspx?did=specialmarkets_m&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3668423%26CatalogName%3DPRIME%26utm_source%3DSpecialMarkets%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing1920-v2%26utm_term%3D3668423 http://www.henryschein.com/redirect.aspx?did=specialmarkets_m&returnurl=/us-en/Shopping/ProductDetails.aspx%3Fproductid%3D3660642%26CatalogName%3DPRIME%26utm_source%3DSpecialMarkets%26utm_medium%3DNxtbook%26utm_campaign%3Dpracticemarketing1920-v2%26utm_term%3D3660642 http://www.henryscheindental.com