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(252) 353-5225


Gamboa Family Dentistry
Andres F. Gamboa DDS


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Patient Forms

New patients: Please fill out the "online" forms. They will be directly and securely transferred to our server and will simplify the data-entry process. If you prefer, you may still do it the old-fashioned way - just make sure you bring them with you.

 
Online Patient Registration Online Medical History Form Crown and Bridge
Temporary Instructions
Post-Surgical Instructions
Printable Medical History
Form in Spanish
Printable Patient
Registration and Medical
History Form
Records Release From Previous Dentist (Print and FAX to Previous Dentist)
 
 


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