
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"
Health History Questionnaire - Two Sided #4054
QTY | 250 | 500 | 1000 | 2000 | 3000 | 4000 | 5000 | 10000 |
---|---|---|---|---|---|---|---|---|
PRICE | $71.40 | $131.60 | $228.20 | $393.40 | $560.00 | $708.40 | $835.80 | $1,614.20 |
PRICE EA | $0.28 | $0.26 | $0.22 | $0.19 | $0.18 | $0.17 | $0.16 | $0.16 |