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IHS421 Page 2 (Rev 5/2017)DENTAL PATIENT MEDICAL HISTORYPatient Name: ___ DOB: ___ Chart #:___
Reason for Dental Visit?___When was your last dental visit? ___Do You Have a Toothache Now? (Please Circle)
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What is dental patient medical history?
Dental patient medical history is a comprehensive record that includes a patient's past health information, medical conditions, treatments, allergies, and medications pertinent to their dental care.
Who is required to file dental patient medical history?
Patients seeking dental treatment are required to file their dental patient medical history, and dental practitioners are responsible for ensuring this information is collected.
How to fill out dental patient medical history?
To fill out dental patient medical history, patients should provide complete and accurate information about their medical history, including current medications, allergies, prior surgeries, and any other health issues relevant to dental care.
What is the purpose of dental patient medical history?
The purpose of dental patient medical history is to inform dental professionals of any medical conditions or medications that may affect dental treatment, ensuring safe and effective care.
What information must be reported on dental patient medical history?
Information that must be reported includes personal identification details, medical conditions, allergies, medications, past surgeries, and any previous dental treatments.
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