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Dental Health History Form

Easily collect the data you need before a dental patient's first appointment.

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Collecting and maintaining a patient's dental history is essential to successful treatment and preventative care. But many dentist offices still use paper forms to gather this data, causing errors and unnecessary manual work. This easy-to-use dental health history form can help you keep an accurate record of patients without the burden of paper. Sections for contact information, prior cleanings, and medical history are included so you can collect all the information you need before a patient's first appointment.

Improve patient experience.

Improve patient experience.

Create a good first impression by adding your branding to this dental history form. The Theme Editor can help you add logos and tweak colors, buttons, fonts, spacing, and messaging. No coding knowledge required! IncludingConditional Logic on your form can add a little personalization by hiding or revealing certain questions depending on a patient's answers.

Empty busy waiting rooms.

Empty busy waiting rooms.

Tired of dealing with busy waiting rooms? Cycle through appointments faster by letting patients complete all necessary forms before they even walk into your office. Formstack's dental history form template looks great on any device. Easily share it on your website or email it out to patients. You'll get the info you need quickly, and patients won't have to fill out paperwork.

Enhance your efficiency.

Enhance your efficiency.

From appointment preferences to insurance details, a lot of information needs to be collected when a new patient arrives at your office. The Portals tool can help you group these forms together in one place so patients can fill them out anywhere. Include this dental health history form in your patient portal, track completion, and send email reminders to late patients.

Protect data with HIPAA.

Protect data with HIPAA.

Keeping security standards top of mind is critical when collecting patient data online. Formstack's HIPAA compliant solution can help you safely capture, store, and export patient health information across any device. User-level permissions, advanced data encryption, audit logging, and dedicated security maintenance make it easy to protect PHI and your peace of mind.

Social Proof

“Using Formstack really reduces the number of potential points for failure when bringing new patients in. It increases the speed and efficiency and cuts down on the duplication of data entry for both patients and staff members.”

Dr. Chris Bojrab,
President at Indiana Health Group

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