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Dental X-Ray Release

Thank you for choosing Archbold Family Dental for your dentistry needs. Please complete the form below before your x-ray appointment, and a member of our team will reach out if we have any questions. If you have any questions, please feel free to contact us.

Dental X-Ray Release

Please fill out our release form in its entirety to ensure we can provide you with the best possible care.

Note: Any fields with * are required.