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CONFIDENTIAL Medical Dental History Form for Patients Under Age 18 American Association of Orthodontists PATIENT Date 0 First name Patient 's last name Prefers to be called Hobbies, activities Birth.

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Dentists should ensure that their patient's medical history is updated appropriately. Typically, dental offices request patients to complete a new medical history form at least every year.

The primary goal of obtaining a medical history from the patient is to understand the state of health of the patient further and to determine within the history is related to any acute complaints to direct you toward a diagnosis[1].

An accurate medical/dental health history is vital since it may provide valuable information for the dentist prior to beginning treatment, especially since certain medications can influence treatment decisions or may impact post-operative care instructions.

Identification data — name, date of birth, phone numbers, and emergency contact information. No financial information should be kept in the dental record. Ledger cards, insurance benefit breakdowns, insurance claims, and payment vouchers are not part of the patient's clinical record.

The past medical history (PMH) in contrast records information about the patient's medical, personal and family history that might be relevant to the presenting illness or to provide optimal clinical management.

Patient history (including symptoms) is recorded in the subjective section. Physical findings and results of diagnostic testing (e.g., imaging, laboratory, electromyographic, etc) are recorded in the objective section.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232