1299 156th Ave NE Ste 115, Bellevue, WA 98007
Locations
901 Boren Ave suite 1733 Seattle WA 98104
Recreational drug and/or alcohol use, combined with local anesthesia may cause a life-threatening emergency.
To the best of my knowledge, the questions on this form have been accurately answered. I understand that providing incorrect information can be dangerous to my (or patient’s) health. It is my responsibility to inform the dental office of any changes in medical status.
