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Record Release Transfer of Xrays

Release Of Records PDF

  • formally request the release of my dental records/radiographs and those of my family members: (print your family member’s names)
  • Please include: (to be filled out by Dr. Sara Syed’s office only)
  • Thank you.


PASSIONATE ABOUT YOUR TEETH


EMERGENCY DENTAL CARE

Call us now if you are experiencing a dental emergency,
we will respond swiftly and be happy to assist you.


613-746-6666





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Copyright by DR. SARA SYED 2019. All rights reserved. Site by SKYFALL BLUE