Dr. Laurence Fendrich - Pompano Beach Cosmetic Dentist Patient Forms

2028 E. Sample Road, Lighthouse Point, FL 33064
Gateway Centre ~ Above Bonefish Mac’s Restaurant
(954) 946-8484 ~ Email

Pompano Beach Cosmetic Dentistry by Dr. Laurence Fendrich

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Forms

Please print and fill out each one of the listed forms and bring it to your initial appointment.

New Patient Forms

Current Patient Forms

Medical History Update

HIPAA Forms

Notice of Privacy Practices

Patient Acknowledgement

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Dr. Laurence Fendrich is a Lighthouse Point dentist providing dental procedures such as cleanings, crowns, teeth whitening, dental implants, and porcelain veneers.

Laurence Fendrich, DMD is licensed as a general dentist in the State of Florida.

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Forms

New Patient Forms

Current Patient Forms

HIPAA Forms