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How do I fill this out?
To fill out the Dental/Medical History Form, start by entering your personal information including your name, contact details, and emergency contacts. Next, provide thorough responses to the medical and dental history questions to help us understand your health needs. Finally, review your answers for accuracy before submitting the form.
How to fill out the Dental Medical History Form?
1
Enter your personal information including name and contact details.
2
Respond thoroughly to the medical and dental history questions.
3
Review all your answers to ensure accuracy.
4
Sign the form where required.
5
Submit the completed form as instructed.
Who needs the Dental Medical History Form?
1
New patients visiting the SLCC dental hygiene clinic need this form to provide necessary health history.
2
Patients who are due for a regular dental check-up should complete this to update their records.
3
Individuals undergoing dental treatments require this form to inform practitioners about their medical history.
4
Parents must fill out this form for their children attending the dental clinic to ensure proper care.
5
Patients who have had recent health changes must submit this form to keep their medical information current.
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2
Use the text tools to make changes to the document.
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4
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What are the instructions for submitting this form?
Submit the completed Dental Medical History Form via email to slcc-dentistry@slcc.edu or deliver it in person at the clinic's front desk. Alternatively, you can fax the form to 801-957-5432. Always ensure that your submitted form is accurate and complete to avoid any delays in processing.
What are the important dates for this form in 2024 and 2025?
There are no specific important dates for this form. It should be filled out prior to your appointments at SLCC dental hygiene clinic rather than based on any fixed deadlines.
What is the purpose of this form?
The primary purpose of the Dental Medical History Form is to gather comprehensive information about a patient's medical and dental history. Accurate completion of the form allows dental practitioners to provide tailored care based on individual health needs. It is essential for ensuring safety during treatments and identifying any potential risks associated with dental procedures.
Tell me about this form and its components and fields line-by-line.
- 1. Last Name: The last name of the patient.
- 2. First Name: The first name of the patient.
- 3. Street Address: The current street address of the patient.
- 4. Cell Phone: The primary contact number.
- 5. Email: The email address for communication.
- 6. Emergency Contact: Name and contact information of an emergency contact.
- 7. Dentist Name: The name of the patient's regular dentist.
- 8. Medical History Questions: List of health questions to determine medical conditions.
What happens if I fail to submit this form?
Failure to submit this form can lead to delays in receiving dental services and risk inappropriate treatment due to lack of necessary health information.
- Incomplete Health Records: Lack of crucial health information prevents tailored patient care.
- Delayed Appointments: Not submitting on time may lead to rescheduling or delays in treatment.
- Increased Risk: Incomplete information increases the risk during dental procedures.
How do I know when to use this form?
- 1. First-Time Patients: New patients are required to complete this form prior to their initial visit.
- 2. Medical Changes: If you have had changes in health or medications since your last visit.
- 3. Annual Dental Checkups: Regular patients should fill this out every three years or as needed.
Frequently Asked Question
Can I edit this form online?
Yes, you can easily edit the Dental Medical History Form online using PrintFriendly's PDF editor.
What do I do if I need help filling out the form?
If you need assistance, please refer to the instructions provided on the webpage for detailed guidance.
Can I save the changes I make?
After editing the form, you can download the updated PDF to your device.
Is it necessary to fill out all sections of the form?
Yes, completing all sections accurately is important for your health and safety.
How do I submit the completed form?
Submission instructions will be provided on the webpage. Typically, you can submit it via email or in person.
What if I make a mistake in my responses?
You can easily edit your responses before downloading the final PDF.
Can I print the form after editing?
Yes, once you edit and download the PDF, you can print it for your records.
Is this form available in other languages?
Currently, the form is only available in English.
What information do I need to provide?
You will need to provide personal details, medical history, and dental treatment history.
Who can I contact for further questions?
For further questions, please contact the SLCC dental hygiene clinic directly.
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