ENDODONTISTS
Dr. Susan L. Micklow & Dr. Branimir Lackovic
101 S Front St., Suite 505 - Marquette, MI 49855
Toll-Free: (866) 642-5569
Phone: (906) 225-4520
Fax: (906) 225-4522
 
Non-Surgical Consent Form
For your convenience, our Non-Surgical Consent Form can be downloaded on your computer and printed out for you to complete at your leisure. Please be sure to bring these completed forms along with any x-rays and referral slips given to you by a referring doctor and any insurance information (and referrals for HMO policyholders), at the time of your appointment. We look forward to meeting you!

Download the "Non-Surgical Consent" form