Patient Authorization Form

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  1. Click on the download button to save this file to your computer.
  2. Locate and open the “Cregar Dental Authorization Form.pdf
  3. This will open the file in Adobe Reader. If you do not have Adobe Reader you can download it here.
  4. Begin filling out the form.
  5. If you are having trouble seeing any of the fields, at the top of the form in the purple bar on the right  is a “Highlight Existing Fields” button. Click this to display what you can fill out.
  6. Please make sure that all the red outlined boxes are completed. Everything else depends upon the individual.
  7. Save the file when you are finished and close it. This form contains your personal information so instead of adding a “submit” button you will:
    • Go to your email
    • Compose a new email to
    • Attach the Cregar Dental Authorization Form.pdf  that you completed and saved.
    • Add a brief message just so we know it’s from you and send.
    • You’re done.

[/vc_column_text][/vc_column][vc_column width=”1/2″][ultimate_spacer height=”50″ height_on_tabs=”50″ height_on_tabs_portrait=”50″ height_on_mob_landscape=”20″ height_on_mob=”20″][vc_column_text]You can view the three page PDF just below to make sure you understand what documents you will need ready to fill out this form.

Moving your cursor over the form will show controls so you can scroll to the next page, zoom in or zoom out.

Once you’re familiar with the form just click on the red download button and the file will be saved onto your computer.[/vc_column_text][vc_column_text]

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