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TREATING DENTIST___ TREATING DENTAL HYGIENIST___PATIENT INFORMATION (Please Print) ___Date:Name: ___ Date of Birth: ___/___/___ Age: ___ MEDICAL INFORMATION: Describe the nature of your children disability:

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How to fill out welcome to our practice

01

Greet the patient warmly when they enter the office

02

Offer them a seat and ask them to fill out the welcome form

03

Provide a clipboard with the form and a pen

04

Explain the purpose of the form and any specific information you need from them

05

Allow the patient to take their time filling out the form

06

Collect the form once they are done and review it for completeness and accuracy

Who needs welcome to our practice?

01

New patients visiting the practice for the first time

02

Patients who have not filled out the welcome form previously

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What is welcome to our practice?

Welcome to our practice is a form that must be completed by new patients before their first appointment.

Who is required to file welcome to our practice?

New patients are required to fill out welcome to our practice.

How to fill out welcome to our practice?

New patients can fill out the welcome to our practice form either online or in person at the office.

What is the purpose of welcome to our practice?

The purpose of welcome to our practice is to gather important information about the new patient's medical history, insurance information, and contact details.

What information must be reported on welcome to our practice?

Information such as medical history, insurance details, emergency contact information, and personal demographics must be reported on welcome to our practice.

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