You are requested to fill out a medical history questionnaire for your first appointment. This is important because many physical diseases and medications can affect the occurrence of problems with your teeth and the performance of dental work. If we are aware of your medical situation, we can take the appropriate precautions. Therefore, it is important that you also inform us of any changes in your medical situation.
"N.B.: Only fill out this form at the request of the practice.
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Lichtenberg tandartsen
Lichtenbergweg 4
2532 AA Den Haag
Telefoon: 070 - 367 90 80
info@lichtenbergtandartsen.nl