Sample Forms

Take advantage of our sample documents — such as allergy warnings, health history and letters — by using them in your dental office.


Failed Appointments Sample Letter Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Health History — Spanish - UPDATED 2021 Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Health History - UPDATED 2021 Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Image Release Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Informed Refusal Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Patient Dismissal Letter Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Reference Check Form Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Referral Letters (all three together) Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Sample Acknowledgment of Surveillance Camera Installation Content Type - Sample Form, State, Alaska, Arizona, California, Hawaii, Illinois, Minnesota, Nevada, New Jersey, North Dakota, Pennsylvania

Sample Employee Manual Content Type - Sample Form, State, Alaska

Sample Employee Manual Content Type - Sample Form, State, Arizona

Sample Employee Manual Content Type - Sample Form, State, Hawaii

Sample Employee Manual Content Type - Sample Form, State, Illinois

Sample Employee Manual Content Type - Sample Form, State, Minnesota

Sample Employee Manual Content Type - Sample Form, State, Nevada

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