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PATIENT INFORMATION EMAIL: MARITAL STATUS: MARRIED SINGLE DIVORCED WIDOWED NAME: (FIRST) (MIDDLE) (LAST) STREET: CITY: STATE: ZIP CODE: DOB: PHONE: Homework Cellphone: Homework CellPRIMARY CARE PHYSICIAN:
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How to fill out smileworks orthodontics health history

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To fill out the Smileworks Orthodontics Health History form, follow these steps:
02
Start by providing your personal information, including your name, date of birth, and contact details.
03
Next, provide your medical history, including any previous orthodontic treatments or surgeries.
04
Answer questions about your dental history, such as any current or past dental issues, fillings, or extractions.
05
Provide information about any allergies or medications you are currently taking.
06
Answer the questions related to your overall health, including any medical conditions or surgeries you've had.
07
Finally, carefully review the form to ensure all information is accurate and complete.
08
Sign and date the form to acknowledge that all the information provided is true and accurate.

Who needs smileworks orthodontics health history?

01
Anyone who visits Smileworks Orthodontics for orthodontic treatment needs to fill out the Smileworks Orthodontics Health History form. This includes both new patients and existing patients who undergo any changes in their health or medical history. The form helps the orthodontist understand the patient's overall health and determine the appropriate treatment plan for them.
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Smileworks orthodontics health history is a comprehensive record of a patient's medical background, including previous dental treatments, medical conditions, allergies, medications, and other relevant health information that can affect orthodontic care.
Patients seeking orthodontic treatment at Smileworks are required to file their health history. This includes children, adolescents, and adults.
To fill out the Smileworks orthodontics health history, patients should complete a detailed questionnaire provided by the clinic, ensuring that all medical and dental information is accurate and up to date.
The purpose of the Smileworks orthodontics health history is to gather essential health information that influences treatment planning, ensuring safe and effective orthodontic care for each patient.
The health history must include personal identification details, medical conditions, previous surgeries, dental treatments, current medications, allergies, and any other health issues relevant to orthodontic treatment.
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