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elcome
to our practice!
For
our new patients
Please follow the
instructions below to facilitate your initial visit
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Please take the time to
carefully fill in the entire medical questionnaire on both sides.
Leave the insurance section empty. If there are any questions,
please leave it blank and ask us!
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Bring a correct
insurance form and/or up to date insurance card.
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Please sign and bring
the privacy practice notice to your appointment. We will give you the
official notice at the time of your visit.
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Please be 10-15
minutes early to answer any questions. Our office strives to be on
time for our patients.
Raymond F. Tinucci, D.M.D.
Family Dentistry
Voice 610.326.8770
Fax 610.326.3935
703 High Street
Pottstown, PA 19464
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