Centennial Park Dental
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Dentist Surname *
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Please indicate if the patient experiences any of the following (you can choose multiple): Heart conditionsHigh blood pressureDiabetesKidney diseaseBleeding tendenciesBlood borne virusSmokerExcessive alcohol consumptionAsthmaChest conditionsEpilepsy/fits/convulsionsLiver diseaseSleep apnoeaPregnant or breast feedingNeurological disordersRecreational drug useOther significant medical condition
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Endodontics
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Other Treatments Required
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