ACKNOWLEDGMENT OF OUR NOTICE OF PRIVACY PRACTICES

ACKNOWLEDGMENT OF OUR NOTICE OF PRIVACY PRACTICES
I hereby acknowledge that I have received or have been given the opportunity to receive a copy of SHANNON NORMAN-KOTRE, DDS, PLLC Notice of Privacy Practices. By signing below, I am “only” giving acknowledgment that I have received or have had the opportunity to receive the Notice of our Privacy Practices.
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KOTRE DENTAL
Shannon Norman-Kotre, DDS Kristin Nickodemus, DDS Sarah Shoukr, DDS A Smile Is Worth A Thousand Words
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