Patient Information
Rodney Schmelzer, MD Plastics, Craniofacial & Reconstructive Surgeon (certified by the Board of Plastic Surgeons) p: 801-743-0700 | f: 801-743-0701 | e: info@craniofacialmd.com | w: www.craniofacialmd.com Patient Information Today’s Date: Patient Name (First, M, Last) DOB Age Gender Home Phone # Patient Address City State Zip Cell Phone # ................
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