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Patient Health History Form - Two-Sided, No Hole Punch

Quickly obtain dental & medical history information with easy-to-use form.

  • Please note: No hole punch.
  • Double-sided form. Printed on both sides on white ledger stock.
  • Checklist format. Forms are designed to prompt responses through a simple checklist format; dentist can quickly scan the completed form & identify problem areas to discuss with the patient.
  • Size: 7 3/4 x 10" scored to easily fold to 5 x 8" card format.

Patient Health History Form - Two-Sided, No Hole Punch

  • $71.40
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