~  Providing Comprehensive Dental Care for Persons with Special Needs  ~

 

Remember!

Consistent dental care is vital to maintain good

oral health.

Make Your Recall Appointment Today!


Forms  


For your convenience you may download and print the required forms and instructions:

New Patient:

Intake Form

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Pre-Op:

Pre-Operative Instructions for Dental Care Under General Anesthesia

What You Should Know About Pre-Sedation and General Anesthesia

Pre-Operative Physical Examination For for Dental Care Under General Anesthesia

Instructions for Care Following Oral Surgical Procedures

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Consent & HIPAA Forms: 

Consent for Pre-Sedation and General Anesthesia

Consent for Comprehensive Dental Treatment under General Anesthesia

Information Regarding Extractions

Notice of Privacy Practices (HIPAA)

 

Special Smiles, Ltd. | 2301 E. Allegheny Avenue | Suite 202 | Philadelphia, PA 19134 | 267-639-6250