AUTHORIZED INDIVIDUALS FOR CHILD (Under 18 Years Old)
Leslie A Wahl, DDS
Serving Pittsburgh, PA, and the Surrounding Areas
412-884-8807
Leslie A Wahl, DDS
Serving Pittsburgh, PA, and 
the Surrounding Areas
Call Us Today

Authorized Individuals for Child Form

Authorized Individuals for Child Form (only needs to be filled out if patients are 18 years old)

This is a list of all of our office forms. New patients please fill out all forms prior to your appointment.
Call for an Appointment
412-884-8807

Click the button below to download and print your own copy of Hipaa Policies

HIPAA Policies 2020
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