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Patient Health History Form - Two-Sided, Two Hole Punch #4046V

Health history questionnaire allows you to quickly obtain comprehensive dental & medical information.

  • Double-sided. Printed on 2 sides on white ledger stock.
  • Simple checklist format. Forms use a series of questions designed to prompt responses through a simple checklist format.
  • Includes: 2-hole punch with check-off boxes.
  • Easy to read. Dentist can quickly scan the completed form & identify problem "yes" areas to discuss with the patient.
  • Size: 8 1/2 x 11"

Patient Health History Form - Two-Sided, Two Hole Punch #4046V

  • $71.40
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