Bridging Brighter Smiles, Inc. – SDF Consent Form

Yog koj muaj lu nug, hu tuaj rau peb los tau, 262-896-9891

Ntawv Tso Cai rau Silver Diamine Flouride (SDF) kho nhiav

  • Qhia txog tus menyuas

  • Date Format: MM slash DD slash YYYY
  • Tej yam Txawv Txav

    1. Cov hniav uas peb siv cov kua SDF yuav pom xim av los xim dub. Thaum nwg hloov xim tshiab dub li no lawm ces txhais hais tias cov kua no pab tus hniav to tsi muaj kab noj ntxiv lawm. Qhoj kws tsis muaj kab noj hniav yuav tsis hloov xim. Qhov xim dub no ces zoo li yog ib qho kiav txhab. Cov hniav uas tsi to yeej dawb dawb xwb tsi dub.
    2. Yog peb luam ntxeej rua tug menyuam cov nqai, qhov nqai ntawv yuav zoo li xim av thiamsis tsis txhob poob siab, yuav tsi ua rau nwg mob thiab ib rau ob hnub xwb nwg yeej yuav ploj mus lawm.
    3. Noj zaub mov yuav tsi qab li zaub mov tiamsi yeej yuav zoo li qub tom qab ob peb feeb.
    4. oj tus menyuam yuav tsi raug txhua yam kev txawv txav no. Yog koj pom tias muaj tej yam txawv tshaj no, thov hu rau peb ntawm tus xov tooj no, 262-896-9891.

  • Lwm Yam Uas Yog tsis Siv SDF Kho Hniav

    1. Yog koj tsi coj koj tug menyuam mus cuag kws kho hniav ces nws tug hniav to yuav phem zuj zus thiab yuav mob loj zuj zus tuaj xwb. Tej zaum tseem yuav tsi muaj hniav thiab.
    2. Dhau ntawm siv cov SDF lawm ces muaj siv moov xuab zeb los nraws cov hniav uas to lawm los sis kab noj lawm, thiab looj cov hniav to, rho cov hniav uas to/kab noj lawm losis lwm yam uas koj tus kws kho hniav xav hais tias yuav pab tau koj tug menyuam.

  • Qhia txog Niamtxiv/Tus Saib Xyuas

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