John J. Kozicki D.D.S. 248.689.9191
  • COVID-19
  • Home
  • About
    • Meet the Staff
  • Our Procedures
    • Bite Guard
    • Bridges
    • Crowns >
      • Post-Op Instructions
    • Dental Implants
    • Digital X-Rays
    • Emergency
    • Extractions >
      • Extraction Post-Op Instructions
    • Hygiene
    • Partials
    • Root Canal Therapy >
      • Post-Op Instructions
    • Whitening
  • Contact
    • Feedback
  • Financing
  • Hours and Location
    • Map
    • Office Policies
    • Insurance
  • Blog
  • Individualized Care
  • New Patient Forms
  • Links
A HIPAA form will be given to you in the office for your signature.  You will have the opportunity to preview our HIPAA Privacy Policy at that time.
​The Health History Form and the Financial Policy are downloadable.  Please print them and fill them out, prior to your first dental appointment here.  Thank you.
Picture
medhis2022.pdf
File Size: 6041 kb
File Type: pdf
Download File

Financial Policy
File Size: 1603 kb
File Type: pdf
Download File

hipaa.pdf
File Size: 288 kb
File Type: pdf
Download File

HIPAA Privacy Practices for the office for you to read only

​hipaapractice.pdf
248-689-9191
The Office asks that you kindly give us 24 hours notice to reschedule any appointments.
Proudly powered by Weebly