Welcome to Hardin Advanced Dentistry! In order for us to get to know you better please take a moment and answer a few questions about your dental experiences.

First and last name: *

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Are you happy with your smile? *

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What would you change about your smile? *

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Are there any areas that are sensitive during a cleaning? Please explain *

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Have you ever had bleeding gums, bad breath or a deep cleaning? *

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Do you snore or have ever had a sleep study? *

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Do dental visits make you nervous? *

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Do you have any special requests or focuses regarding the appointment? Please explain *