TRU Dental, PC
3849 Foothills Rd, Suite A, Las Cruces, NM 88011
Email: office@TRUdentalnm.com
This authority to release includes, but is not limited to: dental reports, clinical notes, doctor’s notes, subjective and objective complaints, radiographs, any pertinent medical information, interpretations of a diagnostic test (including a copy of the report), diagnosis and prognosis, progress notes, prescription history, and any other document records or information in your possession relative to my past, present and future dental condition.