HEALTH HISTORY

DENTAL HISTORY

EMERGENCY CONTACT DETAİLS

Please give the name and telephone number of the closest relative or friend (not living with you) to contact in case of emergency

COSMETİC DENTAL HISTORY(Optional)

Hold a mirror 12-14" from your face. Smile to show your teeth. Take the time to observe your teeth carefully, then answer the following questions. If you are not happy with the appearance of your teeth, ask us how cosmetic dentistry can improve your smile.