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Screening Questionnaire
Do your gums bleed when you brush, eat, or floss?
Do you or someone close to you, feel you have bad breath?
Have you ever been told by a dental professional that you have gum disease or periodontal disease?
Are you at least 18 years of age?
Are you currently on antibiotics or have you taken antibiotics within the past 30 days?
Please check all that apply:
If selected for participation, which location would you prefer?
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