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Section I:Medical HistoryDate Although dental personnel primarily treat the area around your mouth, your mouth is a part of your entire body. Health problems that you may have, or medication that
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To fill out Section I Medical History, follow these points:
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- Begin by providing your personal information including your name, date of birth, and contact details.
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- Specify your current medical conditions or any significant illnesses you have had in the past.
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- List all medications you are currently taking, including the dosage and frequency.
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- Provide details about any allergies or adverse reactions you have experienced with medications or substances.
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- Mention any surgeries or medical procedures you have undergone, along with the dates.
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- Include information about any hospitalizations or emergency room visits you have had.
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- Indicate any family history of genetic or hereditary conditions.
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- If applicable, describe any mental health conditions or psychological treatment received.
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- Finally, sign and date the document to confirm the accuracy of the information provided.
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Section I Medical History is needed by:
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