Checklist Before Closing or Retiring from Practice

A physician can sign this box after confirming your class 1 or class 2 dental status by researching your dental record. No other documentation is required or should be added to the 2808. If there is, you will be required to redo the forms correctly & kindly ask the dentist to correct the error, i.e. no extra stamp should be placed in box 44 or ... ................
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