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Patient Information
Spouse or Responsible Party Information
Assessing Your Smile
Appointment Policy
Consent for Purposes of Treatment,
Payment and Healthcare Operations
Financial Agreement
Assignment of Benefits Agreement
Physical Therapy Techniques
Utilizing the Leaf Gauge Principal
Temporomandibular Joint Pain/Muscle Dysfunction
Home Care Instructions
Take Home Whitening Instructions

En Espaņol
Informacion del Paciente
Informacion del Conyuge o Partido Responsable
Evaluacion de tu Sonrisa
Politica de Citas
Consentimiento Para Proposito de Tratamiento,
Pago y Operaciones de Asistencia de Salud
Acuerdo Financiero
Acuerdo de Asignacion de Beneficios


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Don M Chaney, DDS, PA
Cosmetic and Family Dentistry
2801 Main Drive
Johnson, Arkansas 72741
Phone: (479) 442-3144
Email: info@drchaneydds.com

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