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X-Ray Release Form
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Dental Radiograph Release Form
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Previous Dental Office Name
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I hereby authorize the release of my family's dental radiographs from my previous dental clinic so that they can be transferred to Dental Now Panorama.
Panorex within the last 5 years
Bitewings within the last 2 years
Periapical radiographs within the last 2 years
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Who We Are
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Our Clinic
Our Team
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Dr. Jagatjit Dhillon
Dr. Amardeep Gill
Dr. Do Sung
Our Forms
Expand child menu
Expand
New Patient Form
X-Ray Release Form
How We Can Help?
Expand child menu
Expand
Maintaining A Healthy Smile
How Can I Sleep Better?
Fill Your Cavities
Replacing Missing Teeth
Children’s Dentistry
Restoring your smile
Protect Cracked Teeth
Control Gum Disease
Straighten Your Crooked Teeth
Services We Provide
Expand child menu
Expand
Orthodontics
Expand child menu
Expand
Invisalign
Braces
Myobrace
30 Second Smile Test
General Dentistry
Expand child menu
Expand
Exam
Hygiene
Fillings
TMJ Treatment
Patient Scanning
Teeth Whitening
Emergency Dentistry
Dental Hygiene
Expand child menu
Expand
Periodontal Health