OFFICE SUPPORT DOCUMENTS – MFDO FILE NAME CATEGORY DESCRIPTION LINK Fax Cover Sheet.docx MFDO https://docs.google.com/document/d/16ltKiH42oNGn0MZhjzBLnyfMerPld9gv/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true New patient information intake form.docx MFDO https://docs.google.com/document/d/1eJHmtLl02pvX43Awat4dNZBQOOT3OSJ1/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Emergency Drug Inventory MFDO https://drive.google.com/file/d/1VxOlYywjWvkeO1wZGusbumUUOfQleow4/view?usp=drivesdk Maricopa Family Current Insurance list.docx MFDO https://docs.google.com/document/d/1LKrba6lkCwDVUHJpTfkvcbv5GzNGNdey/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Temp Time Sheet updated 10-9-24.pdf MFDO https://drive.google.com/file/d/1N7uZLP9eSj-rUG8-YmWdvKLX2OoeK_Sy/view?usp=drivesdk Cleaning checkoff list.docx MFDO https://docs.google.com/document/d/19P-ijk2PxjG7-UPlFHtIL-LUCA80FY0a/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Refund of Money and Release_of_Liability MFDO https://docs.google.com/document/d/1AR4v-fP8E5FqG1o7nA3gJHujI8JNvR4setW9zJSCKwI/edit?usp=drivesdk Insurance Direct Deposits 12-1-23.pdf MFDO https://drive.google.com/file/d/1a1kN1aMD6ZatEtV1tC4dbl66oZJYoJB4/view?usp=drivesdk MFDO Sensors MFDO https://docs.google.com/document/d/1qUWGEvc5XES9BL8L8rENxLzQg_IeAS9TkYTIa7NIn2U/edit?usp=drivesdk Core Emergency Drugs.pdf MFDO https://drive.google.com/file/d/1cVS2x1jvj5gl2fTiqVBU_TQ_ssXDy_FG/view?usp=drivesdk Bonegraft Consent.pdf MFDO This is a consent for someone that wants a bone graft. https://drive.google.com/file/d/0B70wJFlgwuiYd29rX1FsU2EyUm8/view?usp=drivesdk&resourcekey=0-QJ0vPnf9Fuy_O5S1f9YDHw Record Release Consent.pdf MFDO https://drive.google.com/file/d/1HE7Jpr0FckwVgQDJ6H-WUA2OrHHQVsSk/view?usp=drivesdk Sedation Flow Sheet updated 9-25-17.pdf MFDO https://drive.google.com/file/d/0B70wJFlgwuiYSExYUnllaEMtQjA/view?usp=drivesdk&resourcekey=0-GbRMPvDqvWRyCvUe8M-XGw Huddle Prep.pdf MFDO https://drive.google.com/file/d/0B70wJFlgwuiYMFIxbTZuNTFucTg/view?usp=drivesdk&resourcekey=0-lDkwsTM-eQjKiLZoM1mP2Q Drug Log & Sedation Instructions.pdf MFDO https://drive.google.com/file/d/0B70wJFlgwuiYb1piYUVyVkhIVW8/view?usp=drivesdk&resourcekey=0-Ur4fob2qca5lOyJG36WhxA Drug Inventory Log updated 9-25-17 MFDO.pdf MFDO https://drive.google.com/file/d/0B70wJFlgwuiYOE9SWnoxSks5bkk/view?usp=drivesdk&resourcekey=0-_gFauNUZ9RGr9j64G8C4yQ HealthGuard_Catalog_Spring_2014.pdf MFDO https://drive.google.com/file/d/0B70wJFlgwuiYYUgtSXhGZTR5SEk/view?usp=drivesdk&resourcekey=0-r7xeYunbftCa5Z9PFvpKfg Auth for CC on file for treatment plans.docx MFDO https://docs.google.com/document/d/0B70wJFlgwuiYWFBCR2REYWh1SW8/edit?usp=drivesdk&ouid=104500706941418853637&resourcekey=0-dvIlSUMOuYYuDrRlAjsaRw&rtpof=true&sd=true Dentrix’s Appointment Quick Fill.pdf Quick fill Appointment https://drive.google.com/file/d/1kQmKyTpX5Hp3FZTs4A16rs0i9-EFlLGB/view?usp=drivesdk Staff Shout Out.pdf Employee Shout out https://drive.google.com/file/d/1PXdqGJu9UCfnl0hFKwM7lxcs3S02U8KF/view?usp=drivesdk SSDP-Consent MFDO.docx SSDP https://docs.google.com/document/d/12bKxKVAlPl2MQqLcKpF2SqVr9U6T-oKn/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true SSDP-Consent MFDO.pdf SSDP https://drive.google.com/file/d/1SJ4j28Ube3sQwsckC6zCb97VSnIm-yhP/view?usp=drivesdk SSDP-Consent MFDO-SP.pdf SSDP-Spanish https://drive.google.com/file/d/1hZxnWnlo5Aw2jb1FpIEMY9GFW0aV49ru/view?usp=drivesdk SSDP-Consent MFDO-SP.docx SSDP-Spanish https://docs.google.com/document/d/1vpaV_NS07f4Z8zWtwJXDanFJzJD-OVap/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true New Ross Edits Conscious Sedation Prescriptions and Instructions.docx Sedation https://docs.google.com/document/d/13zyCr4uA-XoaZsmSroRQjYWjwOvtfS9S/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Copy of Conscious Sedation Prescriptions and Instructions.docx Sedation https://docs.google.com/document/d/1xt5KqZcVQYKtsahdBFACaHSc9xqBmgxa/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Sedation Instructions.pdf Sedation https://drive.google.com/file/d/1BIroftp1eI4TwXHeA0fwyitTRuZzDk0s/view?usp=drivesdk Sedation Flow Sheet updated 11-14-23 MFDO.pdf Sedation https://drive.google.com/file/d/186BZU7Y7uvtfqIBC9LdUoEMB9z5fefI2/view?usp=drivesdk Sedation Post Op Instruction Handout MFDO.pdf Sedation https://drive.google.com/file/d/1xKxGvh-McRDVNBxtxWyGxIo256mooLPW/view?usp=drivesdk Ortho Challenage Revised.pdf Comprehensive Ortho Start Competition https://drive.google.com/file/d/1r5_FONoTcVdgT9AfLnjfk59YOwW36Anb/view?usp=drivesdk New Ada codes 2023_000099.pdf 2023 https://drive.google.com/file/d/1Ztav4i4suFaw_NmNKIl42r_sTMYmquo6/view?usp=drivesdk Refund of Money and Release_of_Liability.docx Patient Dismissal https://docs.google.com/document/d/1oQtj5yDUgMBDxPwJ0AYCoxA0KhIoPH3a/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Termination Letter Due to Non Compliance (1) (2) Patient Dismissal https://docs.google.com/document/d/15ySfQ5bbjTavuP1-ZNaTBF0NVsnhZ26aKcSppt4tdLY/edit?usp=drivesdk Maricopa Ext Spanish Post op Instructions SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IQ0RhNWtLRXYzUTA/view?usp=drivesdk&resourcekey=0-tqMhgW7oNcBXplmCUxlVGg Nitrous-Oxide-Informed-Consent MFDO.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/1LW6YopqNWRp6Y17B_2MiXJ2zxlbmZzBc/view?usp=drivesdk Nitrous-Oxide-Informed-Consent MFDO.docx Pt Forms & Consents – Spanish https://docs.google.com/document/d/1jh4FAs1W87uHoBqlngGvXHv8raSKcGUz/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true All-On-4 Pre-Op -MFDO.docx Pt Forms & Consents – Spanish https://docs.google.com/document/d/1wzEFLh-uH1dED28mYPCyQYHmTcz20My8/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Pt hand out SRPs-MFDO SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/1xY1-gpRaw_8iPfeKOb3sZvdHA4SO4QD2/view?usp=drivesdk MFDO LTW Application Guide SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IR2xpSVNxWUxBUDQ/view?usp=drivesdk&resourcekey=0-Ee0bClIFJvvps5nEJ9AtFw Maricopa Endo Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IeTM0UEZoZjhuZUU/view?usp=drivesdk&resourcekey=0-V77bEUZdwbnycdmmEjFS-g Maricopa Boot Camp SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IczJfYklmNWVNUDQ/view?usp=drivesdk&resourcekey=0-TKFSg8Hpb4jqKetgnbOSNg Maricopa Debnd Consent SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-Id2d1R2JaVU4yZFE/view?usp=drivesdk&resourcekey=0-aJC9Nxrrjpau4ClpKZyMWw Maricopa Bonegraft Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IRHNiZ1ZJWmVVU3M/view?usp=drivesdk&resourcekey=0-Wse0wyDOeSAaHCDrwgyWAQ Maricopa Surgical Exposure of an Impacted tooth SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IOEVZODh6S0VKaWc/view?usp=drivesdk&resourcekey=0-99U0XPpNd6oB-5g7QXr23w Maricopa Sinus Augmentation SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IRmlEbTZWVnVoY1k/view?usp=drivesdk&resourcekey=0-w6n8SuNeaUYbnqaQ_VkPuA Maricopa Ortho Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IVkw1LTc3MlV5Rnc/view?usp=drivesdk&resourcekey=0-2F8tUWwxCavp2ISBkqDrow MFDO Conscious Sedation Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IY3VvNnBidWdnTlU/view?usp=drivesdk&resourcekey=0-f836DdrA7nraKHw8d78MGA Maricopa Rmv Amg Fill SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-Ic1NQdEtrMW1kWm8/view?usp=drivesdk&resourcekey=0-Nty5M08FuTUfLf-GPIf4JA Maricopa Xray Refusal SP (2).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IOHQ5bXZHQUdJdXM/view?usp=drivesdk&resourcekey=0-bI1TXvSRH4Qfk16KUf1-NQ Maricopa Refusal of Perio Txment m SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IT2VnZXRhNGFwRHM/view?usp=drivesdk&resourcekey=0-ipP7ejlH7Z0fR56TEwzdqw Maricopa Release records SP (1).pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IYk94LURFRUg2TVk/view?usp=drivesdk&resourcekey=0-ToLadK9mp4uTSEHDpu5dvQ Maricopa Lifetime Whitening Consent.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IbFBSU0RWdVQ5QTA/view?usp=drivesdk&resourcekey=0-hu7PyRpm1VeHctJ0BEkDBA Maricopa Implant Post-Op Instructions SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-Idm1sUUlCaERBSjg/view?usp=drivesdk&resourcekey=0-pH1OwDNJiU6cyU_JCmXVCg Maricopa Ortho Care Instructions SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IX0dNSEhPUVRNOEE/view?usp=drivesdk&resourcekey=0-DZs0myJq9XLhjEJoHiDKrg Maricopa Implant Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IdzVLNjZWMzFMRjg/view?usp=drivesdk&resourcekey=0-NyBgvLU4GV3j-NP-S3CFRg Maricopa EXT Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IelNiblhXT01YQ0U/view?usp=drivesdk&resourcekey=0-QheyEYRSHFK36WaPYFNhig Maricopa General Dentistry Consent SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IekhVWlJlUGliNG8/view?usp=drivesdk&resourcekey=0-rzSmYrgj1Ih2DukenIDaQw Maricopa Financial Option Sheet SP.pdf Pt Forms & Consents – Spanish https://drive.google.com/file/d/0B_1WKt4xgx-ILVp1WG03V0I0eG8/view?usp=drivesdk&resourcekey=0-LdqnO-Ha6pN0mPr7P_4-_g Spanish Medical History- MFDO.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/1zwew4wGunXePxYeoB6LxU9rZ6utDidyR/view?usp=drivesdk Office Policies- Spanish MFDO 12-11-23.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/1IlZvoTLFAzpHj2K6mNyMYUITs1_gedEK/view?usp=drivesdk Spanish-MFDO Notice of Privacy Practices.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/0B_1WKt4xgx-IWlZtM09FYjdVNXM/view?usp=drivesdk&resourcekey=0-bgrGAAjlATAt0BiCPS5KTg Spanish Pt info- MFDO.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/1FwEqooNb6SqsLc6kWefQbUDfVhXmMmQF/view?usp=drivesdk Spanish-Medical Hx and Dental Hx- MFDO.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/1RZpsYw6uhCBffNsoGUr4_X-xwnFBxytx/view?usp=drivesdk NP Paperwork Pt Information.docx New Patient Paperwork- Spanish https://docs.google.com/document/d/1biFIcFwlQaNy70prRhtiQpggNVD8YytO/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Medical Hx and Dental Hx- MFDO.pdf New Patient Paperwork- Spanish https://drive.google.com/file/d/1l50QC6uuvlrxfWJLBOAe4a0KirnPJSan/view?usp=drivesdk SSDP Consent Updated 10-24-24.pdf Pt Forms & Consents – English https://drive.google.com/file/d/1Ty2qcsRcMs76BvmMOSsDGQ6m6WspFvS7/view?usp=drivesdk Crown Acceptance Consent-Mfdo.pdf Consent forms- English https://drive.google.com/file/d/1DJjXB1U6y8monB1-NJ0zhJ5cOQxjggkM/view?usp=drivesdk INFORMED CONSENT FORM FOR PATIENTS UNDERGOING CLEAR ALIGNER ORTHODONTIC TREATMENT (1).pdf Consent forms- English https://drive.google.com/file/d/1l4DiHHfAPRlA9q8xhHNYM0ASeM9KjUj8/view?usp=drivesdk Medical Clearance.pdf Consent forms- English https://drive.google.com/file/d/0B70wJFlgwuiYQnRsZ3kyN0c4VHM/view?usp=drivesdk&resourcekey=0-R_JXdv8wer-YI9q72pqw5Q INFORMED CONSENT FORM FOR PATIENTS UNDERGOING CLEAR ALIGNER ORTHODONTIC TREATMENT .pdf Consent forms- English https://drive.google.com/file/d/1gYduMbyedUSFTRAopZK9FORpwRUVXF4D/view?usp=drivesdk INFORMED CONSENT FORM FOR PATIENTS UNDERGOING CLEAR ALIGNER ORTHODONTIC TREATMENT Consent forms- English https://drive.google.com/file/d/1oG-6DGOqqcPv692pfhMLTVMzdIbBL2Uz/view?usp=drivesdk Orthodontic Deband and Retention Consent MFDO.pdf Consent forms- English https://drive.google.com/file/d/1s56B3pB5D9fmZlAmLcD6yppVeiKTYpTI/view?usp=drivesdk Model Release-revised 12.6.22.pdf Consent forms- English https://drive.google.com/file/d/1Ws53dS1v4wLeIB2_IIzdIqZa2QpwzQMJ/view?usp=drivesdk Termination Letter Due to Non Compliance Consent forms- English https://docs.google.com/document/d/1pn9qu-eGa4gMWv65TzDgjkjV9R0vjWxkLyHr8fVEhdY/edit?usp=drivesdk Implant Failure Consent Refund Consent forms- English https://drive.google.com/file/d/1iUUTin5U-r79FiFIjA75tAYBHRTIeh2V/view?usp=drivesdk Implant Failure Consent Refund Consent forms- English https://docs.google.com/document/d/1RC0u4GUKUGbjZVeFOsgriWCA6xgQl0-zGmp-r7rCJx8/edit?usp=drivesdk Bonegraft Consent.pdf Consent forms- English https://drive.google.com/file/d/1pSHt39bGs_TnThuQKnlPdjePrqDWYVY/view?usp=drivesdk All-on-4 Post Op MFDO.docx Consent forms- English https://docs.google.com/document/d/1mgAhfOiYbBAGSeoZFcRV3D7EG4LbV0Qm/edit?usp=drivesdk&ouid=104500706941418853637&rtpof=true&sd=true Maricopa Release of Records.pdf Consent forms- English https://drive.google.com/file/d/1XShJvHHCOsREs3qi5z6h-EmoXtRsdKZG/view?usp=drivesdk Employee Orthodontic Consent.pdf Consent forms- English https://drive.google.com/file/d/1IL-dFLcXEPvkR9pYr-c4fpY42sUkcBBs/view?usp=drivesdk Lendingpoint Consent.pdf Consent forms- English https://drive.google.com/file/d/1fj9Cw9gq2Vnzs74Ki4crvAKfjrzDxWbZ/view?usp=drivesdk Silver Diamine Fluoride-MFDO.pdf Consent forms- English https://drive.google.com/file/d/1KorMFO3e7r-2TNA8bzKRUC6kDKc0lHef/view?usp=drivesdk Ortho Consent-Revised 3-26-19.pdf Consent forms- English Description test https://drive.google.com/file/d/1o3kJ2nvXIE7GQlZstDbLhFOk4jGnRfwE/view?usp=drivesdk PostOp Oral Surgery MFDO.pdf Consent forms- English https://drive.google.com/file/d/1Tc6MaQBLGfpBMMjioAc_YKrfWBKiEFTa/view?usp=drivesdk PRF 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