Susan L. Micklow, D.D.S., M.S.
"Specialist in Endodontic Care"
101 S Front St., Ste. 505 - Marquette, MI 49855
Toll-Free: (866) 642-5569
Phone: (906) 225-4520
Fax: (906) 225-4522
 
Parental Consent Form
For your convenience, our Parental 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 "Parental Consent" form