Dental and Medical Histories - Updates

In-depth, easily - updated history form

It is the dentist's responsibility to obtain a dentally relevant history from the patient. Such histories must be routinely reviewed to be sure that information is current. Our form makes it easy to comply.

Dental History - Our questions are arranged in alternating fashion - No/Yes, No/Yes. An answer out of sequence spotlights a possible problem.

Medical History - Our form is very detailed. Use a highlighter to focus attention on important responses; use a red pen to make notes. A medical "alert" label can be placed on the outside of the folder in the appropriate section 

Medical Updates - Changes in a patient's general health can be noted quickly. A section for the patient's and dentist's signature is provided.

  • Accepted format for adults and children - exams or emergencies
  • "Yes" and "No" answers cannot be overlooked
  • Information on specific allergies and medications
  • Premedication alert
  • Review area
  • Medical updates on same convenient form
C-113L Dental and Medical Histories - Updates
$18.00 / 200 $34.00 / 400
$64.00 / 800 $120.00 / 1600



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