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Fairfax Oral and Maxillofacial Surgery: Implant Patient Evaluation

This question requires a valid date format of MM/DD/YYYY.
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8. If you are missing teeth, has that loss led to or affected any of the following?  *This question is required.
9. Which of the following are most important to you? *This question is required.
10. What other concerns do you have?  *This question is required.