{"product_id":"form-100-6c","title":"Form 100-6C - Patient Information and Health Questionnaire (Chinese)","description":"\u003cp\u003ePatient Information and Health Questionnaire (Chinese)\u003cbr\u003eMost comprehensive form of its type\u003cbr\u003eChinese version of 100-6\u003cbr\u003eFinancial and Insurance information\u003cbr\u003eTerms and Conditions\u003cbr\u003eMedical History\u003cbr\u003eDental History\u003cbr\u003eConsent for treatment\u003cbr\u003ePatient reviews his or her history, listing any changes, then dates and signs\u003cbr\u003ePrinted 2 sides\u003cbr\u003e8.50” x 11”\u003cbr\u003eBlack ink on white stock\u003cbr\u003e100 per pad.\u003c\/p\u003e","brand":"4 Dental Docs","offers":[{"title":"Default Title","offer_id":48046758199554,"sku":null,"price":29.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0825\/9908\/4290\/files\/100-6CPatientInformationFormChineses1.jpg?v=1782499684","url":"https:\/\/4dentaldocs.com\/products\/form-100-6c","provider":"4 Dental Docs","version":"1.0","type":"link"}