Confidential Medical History Form
Shiraz, 389 Warwick Road, SolihullWest Midlands, B91 1BJTel: 0121 709 1660
Like all dentists, we ask patients for information about their general health to help us treat them safely. Please complete this form, which Dr Vahdaty will discuss fully with you before commencing treatment. If you have any questions, please ask Dr Vahdaty. All information will be kept completely confidential. Thank you.
MEDICAL HISTORY UPDATE