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  • Patient Info
    • View All Patient Info
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FORMS

Patient Forms


Patient Forms

Please click on the link(s) below to download our forms. Please print and complete the forms prior to your appointment and bring them with your insurance card to your appointment. If you are unable to print the forms, please plan to arrive 10-15 minutes early for your appointment so that you can complete them in our office.

Patient Information Form – Child
Patient Information Form – Adult
Patient Referral Form
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Michele Shems DMD
202 US Route 1 Falmouth, ME 04105
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