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Sample Forms

We’re here to make record keeping easier and more efficient so you can better protect your practice. View, download and customize the right resources for your state. Find sample forms and letters to support documentation, employment, general liability and patient care.

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Cybersecurity Reference Guide

An overview of cyber risks, common data breach and cyberattack targets, investigations, preparation and prevention

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Diagnostic X-rays Are Required Letter

Sample letter to inform and educate a patient of necessary X-rays for comprehensive care.

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Failed Appointments Letter

Sample letter to a patient who continues to miss dental appointments to address needs and consequences

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Informed Refusal of Recommended Dental Treatment

Form acknowledging a patient's refusal of recommend dental treatment, test, or evaluation.

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Referral Follow-Up for Evaluation and/or Biopsy of Suspicious Area/Lesion Letter

Sample patient letter for follow-up on referral for evaluation or biopsy of suspicious lesion.

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Referral Letters (set of three)

Letters providing referrals to patients, a follow up letter and letter to the referral provider.

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