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Page 1 of 2Smile StartersGeneral Dentistry for Youth first tooth through age 20Health History Patient\'s Name: First Date of birth: Month Dental History:Last DayYearWhat brings you to the dental office
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How to fill out smile starters health history

01
Start by gathering all necessary information such as personal details, contact information, and emergency contact details.
02
Proceed to fill out the sections related to medical history, including any existing medical conditions, allergies, and medications being taken.
03
Provide information about dental history, such as previous dental treatments, any ongoing oral health issues, and any dental fears or anxieties.
04
Answer questions related to lifestyle choices, such as smoking or alcohol consumption, as they may have an impact on oral health.
05
Ensure to read and understand all the questions before providing accurate and honest answers.
06
Double-check all the information filled out to ensure accuracy and completeness.
07
Submit the filled-out health history form through the designated channels as instructed by Smile Starters.

Who needs smile starters health history?

01
Anyone who is planning to visit Smile Starters dental clinic for the first time
02
Individuals who are seeking dental care and treatment from Smile Starters
03
Both adults and children who are looking to become patients at Smile Starters
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Smile starters health history is a form that collects information about a patient's medical history, current medications, and any pre-existing conditions.
All new patients at Smile Starters dental clinic are required to fill out the health history form.
Patients can fill out the health history form either online through the clinic's website or in-person at the clinic before their appointment.
The purpose of the health history form is to ensure the dental team has all necessary information to provide safe and effective treatment.
Patients must report any medical conditions, allergies, medications, surgeries, and previous dental treatments on the health history form.
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