This form should be completed by each new patient or a new patient’s legal guardian. Additionally, it should be reviewed at least every six months and completed every two years by active patients. This form provides the practice a comprehensive report of a patient’s health history, including essential dental health history information. The form can be completed at the start of a patient’s appointment or prior to the appointment as long as the information is still current when the patient presents. Each health care provider should review the form in advance of treating the patient. Be certain to allow time in your schedule for this review.
Certain areas of medical information bear confidentiality restrictions: