By completing this form, you, the dentist, agree that any information that you receive about this new program from Curtis Group will be kept confidential, to be shared only with other dentists or employees in your dental practice. Such dentists and employees shall also be advised that this information is confidential and protected.

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Request an information-only consult.

Submitting this form indicates that you agree to a general non-disclosure agreement about any information received during the subsequent consultation with Mark Curtis.