Get the free OrthoHistory.doc

Orthopedic HISTORY Name Date SS#: Date of birth: CHIEF COMPLAINT: Why are you seeing the doctor today? Current problem is the result of: (check all that apply) Car accident Work accident Other Medication

How to fill out orthohistorydoc

How to fill out orthohistorydoc:

1. Start by opening the orthohistorydoc form on your computer or device.
2. Enter your personal information in the designated fields, including your name, date of birth, and contact details.
3. Provide relevant medical history by answering questions about any previous orthodontic treatment, surgeries, or dental conditions.
4. Indicate any allergies or sensitivities you may have, especially related to dental materials or anesthesia.
5. Describe your current dental concerns or issues that led you to seek orthodontic treatment.
6. Specify any medications you are currently taking, including dosage and frequency.
7. Include information about your oral hygiene routine and any oral health issues you may have, such as gum disease or tooth decay.
8. Provide details about your dental insurance, if applicable, including the provider and policy number.
9. Sign and date the orthohistorydoc form to certify that the information you have provided is accurate.

Who needs orthohistorydoc:

1. Individuals seeking orthodontic treatment: Anyone considering orthodontic treatment, such as braces or aligners, will need to fill out the orthohistorydoc form.
2. New patients at an orthodontic practice: When visiting a new orthodontic office, patients will typically be required to complete the orthohistorydoc form to provide the orthodontist with their medical and dental history.
3. Existing patients updating information: Even if you have filled out the orthohistorydoc form in the past, you may be asked to update the information periodically to ensure the orthodontist has the most up-to-date details about your oral health and medical history.

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