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WELCOME TO OUR ORTHODONTIC OFFICEARTHUR L. KAPUT, D.D.S., M.Sc. D., P.A. PATIENT INFORMATION Patient Name: Today's Date Last First MI Male Female Mr. Mrs. Ms. Miss Dr. Date of Birth Home Address:
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Open the ortho-health-history-adultsdoc document.
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Start by filling out the personal information section, including your name, date of birth, and contact information.
03
Move on to the medical history section and provide accurate details about any previous or current health conditions, medications, allergies, surgeries, or hospitalizations.
04
Fill in the dental history section, noting any orthodontic treatments you've undergone, past extractions, and jaw problems.
05
Proceed to the dental insurance section if applicable, and provide the necessary information about your insurance provider and policy.
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Lastly, review the completed form to ensure all sections are properly filled out and no information is missing. Sign and date the document before submitting it to the relevant party.

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Ortho-health-history-adultsdoc is needed by adults who are about to undergo orthodontic treatment or evaluation. It is also required by dentists or orthodontists as part of their patient intake process to gather detailed information about the patient's health and dental history.
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Ortho-health-history-adultsdoc is a medical form that records the health history of adult patients.
Adult patients visiting an orthodontist are required to fill out and file ortho-health-history-adultsdoc.
Patients need to provide accurate information about their medical history, current medications, allergies, and any existing health conditions.
The purpose of ortho-health-history-adultsdoc is to help orthodontists understand the patient's medical background and provide appropriate treatment.
Patients must report their medical history, current medications, allergies, prior surgeries, chronic conditions, and any other relevant health information.
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