Templates Business Operations Dental History Form Template

Dental History Form Template

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Previous Dentist Address
Do you have any chronic medical conditions?
Are you currently on any medication?
Do you have any allergies?
Have you ever undergone dental surgery?

Do you run a dental practice? You’ll need a few different forms to help keep things organized. One of these is a dental history form template that allows you to collect crucial information before you begin work on any patient. The WPForms’ Dental History Form Template is ideal for this.

What Makes a Good Dental History Form Template?

As you know, dental treatment can be risky if patients have underlying conditions, and certain procedures may not go according to plan if patients have had undisclosed dental work done. This makes it important for a dental history form to be thorough. And the WPForms’ Dental History Form Template is just that!

The form begins with the basic Name, Email, Phone, and Address fields. Next, it has a single-line text field asking for the name of the patient’s previous dentist. This is important in case you need to discuss some aspects of their previous treatment. The template also includes an email and phone field for collecting the details of the previous dentist, but these fields are not required in case patients do not remember or do not have these details for any reason.

There are a few more helpful fields on the template. These include a series of dropdowns with corresponding Paragraph Text fields that are hidden or displayed based on conditional logic.

For example, there is a dropdown asking if patients have any chronic medical conditions. If they choose yes, this will trigger a Paragraph Text field where they’ll be prompted to provide details.

Get started with WPForms today to create and customize your own dental history form. Signing up with WPForms gives you access to this and hundreds of other pre-made templates.