040 380 80 808 praxis@citymedent.de

Anamnesebogen englisch

Also general diseases can have effects on the dental-medical treatment. So we ask you to fill out this questionnaire. This is added to your personal doucuments.

Please note that this Information are liable to medical discretion. They serve exclusively to adapt our
teartment to your state of health. Partly they are regulated by law.

If it is necessary, your data are stored by us. But they subject to strict conditions of privacy.

 

Medical anamnesis