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Patient Forms

Dr André Malan,
Create the smile you've always wanted... or preserve the one have.
(801) 394-3767     E-mail:
info@drandremalan.com
 3860 Jackson Avenue Ogden, Utah 84403

 

All new  patients are required to fill out an Acquaintance and Health History Form prior to treatment. f you would like to save time on your first visit, please click the link below. You will need to print both forms. Thank you.

Click here for: Adult Acquaintance and Health History Form

Click here for: Child Acquaintance and Health History Form

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