Authorization for Release of Dental Records
Form for patient to authorize release of records to another dentist, physician or authorized representative.
Case Completion and Esthetic Approval
Sample form for esthetic approval of dentures or partials and permission to proceed with their completion
Consultation for Dental Treatment
Form for mutual patient’s physician to confirm medical condition, diagnosis and/or fitness for dental treatment
Dental History Form
Sample form for capturing a patient’s at-home oral hygiene, dental concerns and treatment history.
Diagnostic X-rays Are Required Letter
Sample letter to inform and educate a patient of necessary X-rays to continue dental treatment.
Dispensing Products Acknowledgment form
Sample acknowledgment form to document products dispensed to a patient. Does not apply to medications.
Emergency Phone Screening to Determine Appointment Immediacy
Form to facilitate patient screening by phone and determine immediacy or appointment or emergency care.
Sample form for esthetic approval of dentures or partials and permission to proceed with their completion.
Failed Appointments Sample Letter
Sample letter to patient who continues to miss dental appointments to address needs and consequences.
Some browsers will provide an option to save the file to your computer/device, others will automatically download the file to your downloads/files folder.