These proven forms capture patient health history quickly & comprehensively! Questionnaire covers both dental & medical information.

• Please note: No-hole punch.
• Easy to read. Dentist can quickly scan the completed form & identify problem "yes" areas to discuss with the patient.
• Simple checklist format. Forms use a series of questions designed to prompt responses through a simple checklist format.
• Double-sided. Printed on 2 sides on white ledger stock.
• Size: 8 1/2 x 11"