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HEALTH HISTORY First Name___Last Name___ DOB___DENTAL HISTORY Do your gums bleed when you brush or floss? ( )Yes / ( )No Your teeth sensitive to cold, hot, sweets or pressure? ( )Yes / ( )No Does
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Start by obtaining the patient forms from Smiley Pearls dental clinic.
02
Carefully read all the instructions and information provided on the forms.
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Begin filling out the forms by providing personal details such as your full name, contact information, and date of birth.
04
Proceed to enter your medical history, including any pre-existing conditions, allergies, and medications you are currently taking.
05
Provide insurance information if applicable and fill out any relevant sections related to dental coverage.
06
If you have any specific dental concerns or treatment requests, make sure to mention them on the forms.
07
Review all the filled information for accuracy and completeness.
08
Sign and date the forms to signify your consent and agreement with the provided information.
09
Submit the completed patient forms to the reception desk at Smiley Pearls dental clinic.
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Ensure you keep a copy of the filled-out forms for your records.

Who needs smiley pearls patient forms?

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Anyone who is planning to visit Smiley Pearls dental clinic as a new patient or for a follow-up appointment needs to fill out the patient forms.
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Smiley Pearls patient forms are documents that patients fill out to provide necessary information for their medical records and treatment at Smiley Pearls facilities.
All patients seeking treatment or services at Smiley Pearls are required to file the patient forms.
Patients can fill out the Smiley Pearls patient forms by providing accurate personal information, medical history, insurance details, and signing where indicated. Forms can typically be completed online or in person.
The purpose of Smiley Pearls patient forms is to gather essential information for patient care, ensure accurate medical records, and facilitate communication between patients and healthcare providers.
The information that must be reported on Smiley Pearls patient forms includes the patient's name, contact information, medical history, current medications, allergies, and insurance details.
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