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Forms

Below is a compilation of informational forms, questionnaires, and instruction sheets used at Revive. For new patients, please feel free to print out the Patient Information form, HIPAA Compliance form, and the Revive Questionnaire and bring them with you to your consultation. Generally, a diagnosis can not be made by simply taking a questionnaire, so please set-up a consultation if you suspect you need treatment.

OFFICE HOURS:

By appointment only​

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OFFICE ADDRESS:

9345 W. Sunset Rd #100

Las Vegas, NV 89148

 

PHONE:

725-605-1599

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EMAIL:

hello@revivehealthandwellnesscenter.com

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© 2020 by Revive Orofacial Therapy and Wellness Center

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