He encontrado que alguna farmacia puede tener existencias limitadas de ciertos medicamentos, mientras que otras pueden tener casi cualquier formato que se le ocurra y el habitual de dosis habitualidad apareció. En resumen, siempre se contiene el almacén de corroborar. Al mismo tiempo que el producto que más que gustaba ha resultado no estaba disponible en stock otro distinto por las Buenas costumbres también debe buscarse jefe no asн parezca. Por eso es importante disponer de un Plan B para actuar cuandod ello no ocurra. Ventaja de tomar un genérico en lugar de Asix Un genérico es más barato que el nombre de marca Uno de los mayores incentivos para someterse al Dónde comprar Lasix genérico en lugar de pagar la marca es que usted puede obtener un ahorrando importantes Lasix genérico. Por lo tanto, un Lasix genérico es en general mucho más barato que el homólogo de marca, así que una denominación genérica se hace posible para las personas que usan este medicamento con frecuencia. Un ejemplo: La compra de lurosemida en lugar de Lasix es una considerable ahorro para el presupuesto mensual de medicamentos.

Southerndentalgroup.net

We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as completely as you can. We are
looking forward to working with you on maintaining your health.
Patient Information
Patient_____________________________________________________Sex: M F DOB:___________________ Marital: S M W D Address____________________________________ _______City _______________ State ____________ Zip __________________ Home Phone _______________________Cell _____________________SS # ___________________Pharmacy _________________ Email ______________________________________Occupation/Employer _____________________Work Phone_______________ Who should be notified in case of an emergency?____________________________________ # ______________________________ How would you prefer for us to contact you? Home phone Work phone Cell phone Whom may we thank for referring you to our office? _________________________________________________________________ Primary Dental Insurance
Insured’s Name___________________________Relationship ________________ DOB ______________SS#___________________ Address_____________________________________________________________________________________________________ Employer _______________________________ _Insurance Co.________________________________________________________ Secondary Dental Insurance
Insured’s Name___________________________Relationship ________________ DOB _________ _SS#______________________ Address_____________________________________________________________________________________________________ Employer _______________________________ Insurance Co._________________________________________________________ Medical History
Former Dentist___________________________ Address_________________________________ Phone # _____________________
Physician’s Name___________________________________ Phone # ____________________ Last Visit ______________________
Are you currently under a physician’s care? ________ _If yes, describe __________________________________________________
Have you ever been hospitalized, had major operations or serious illness? ________________________________________________
Have you ever had a blood transfusion? _________ If yes, give approximate dates _________________________________________
Women: Do you suspect that you are pregnant? ______Are you nursing? _______ Do you take birth control pills?________________
Do you use any tobacco products? _______What kind? ________________ How long? ________How much per day?_____________
Please check if you currently have, or have ever had any of the following:
__ Mitral Valve Prolapse
Are you taking or have you ever taken bone replacement medications? (Ex. Boniva, Fosamax, Actonel, Zometa, etc.) _____________
____________________________________________________________________________________________________________
List any medications you are currently taking_______________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
List any drug allergies__________________________________________________________________________________________
- I authorize the release of my dental records and medical information to Dr. Michael E. Pope.
- I consent to treatment considered necessary by the dentist or qualified designate.
Signature______________________________________________________________ Date ________________________________

Source: http://www.southerndentalgroup.net/docs/patientwelcome.pdf