Confidential Notes

This form can be used with the C-301R Dental Treatment Record - Progress Notes (Piggyback Option) or with the C-101R Dental Treatment Record - Progress Notes.

Fees, accounts receivable, patient contracts, insurance company notes, interoffice communication and personal notes which are not a part of treatment, can be kept separate from treatment notes. Messy, inefficient paper-clipped notes containing non-treatment information can be eliminated.

If a record is requested by a patient, a specialist, another dentist or third party insurance, only the top form C-101R or C-301R need be provided. Order separately from Starter Kit. 

  • Fee - Not part of "Progress Notes"
  • Confidential notes - not part of patient record 
C-401R Confidential Notes (Not part of patient record)
$18.00 / 200 $34.00 / 400
$64.00 / 800 $120.00 / 1600

In case of litigation, consult legal counsel concerning Confidential Notes portion of record.



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