Consent for Records Release (text only)
Please read this Consent for Records Release below and sign the English version at https://mdvdds.com/rr-consent
Spanish, Arabic and Persian versions are available by making a selection on the flag at the top right of this page.
If you have any questions call us on (615) 915-6090.
Please send dental and health history records as well as ISP and Risk Tool information for:
Patient date of birth
Dr. Michael D. Vaughan, DDS and Associates
330 Wallace Rd, Ste 106
Nashville, TN 37211
fax: (615) 915-6091