The Dental Record

ADA Business ResourcesSM is a service mark of the American Dental Association.

ADA Business Resources is a program brought to your by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association.


Become a fan on Facebook

Follow us on Twitter

View our photos on Flickr

You Tube

Registration and Patient History Forms

The Registration form has areas to record the patient's name, address, phone number(s), employer, Social Security number, insurance information, and a place for the patient's signature to give authorization for treatment, and release of information

Changes in history or medications can be recorded on the Medical History Update form.

The Dental History form is important because it records the patient's purpose for the initial visit.

The Medical History form tracks vital information pertaining to adults. It is included in The Basic Record, The Complete Record, and The Flexible Record

General Information | Digital Dental Record | Catalog & Online Store | Paper Forms & Charts
Prescription Pads/Paper | Additional Solutions | News & Events | Fun Stuff | Links | Site Map | Contact Us

© 2009 The Dental Record® • All Rights Reserved
Wisconsin Dental Association, 6737 West Washington Street, Suite 2360, West Allis, WI 53214
(414) 276-3954 • (800) 243-4675