• Tompkins Dental

  • HEALTH SERVICES

    Patient Appearance Approval

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  • I have seen my CROWN today and approve of its appearance.

    Including teeth, shade, shape, size, and position of artificial teeth and their relationship to my natural teeth (if any).

    I am aware that this office (Tompkins Dental) will not be responsible for any further changes in the color, shape or position of the teeth.

    I understand that if I request any changes after processed stage of crown, I will bear the financial responsibility.

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