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Exam Forms

The Clinical Examination form helps determine the exact condition of the patients when they walk in the door of your practice.

The Recall Examination form gives you four recall appointments on a single sheet.

The Periodontal Screening Examination form helps you screen according to definitions of probing, bleeding, mobility, furcation, and recession. Three exams are available per sheet.

The Treatment Plan form allows for a written statement of the services that you plan to perform. It shows that you planned for the conditions you diagnosed, prioritized your treatment, and used a logical approach to providing treatment.

The Progress Notes form helps you detail everything that happens during the course of treatment and between visits.

The Dental Record Treatment Schedule Card is the link between the patient's chart and their treatment. It lets you skip the computer search or record pulling when patient appointments are scheduled or changed. All planned treatment that is not scheduled is kept on this card, and you cross out each treatment as it is rendered.

Appointments Necessary form

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Wisconsin Dental Association, 6737 West Washington Street, Suite 2360, West Allis, WI 53214
(414) 276-3954 • (800) 243-4675