University of Louisville School of Dentistry Health History Form Preview on Page 1

University of Louisville School of Dentistry Health History Form 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name and date of birth in the designated fields at the top of the form.
  3. Indicate the reason for your dental visit today in the provided space.
  4. Answer whether you are currently under a physician's care by selecting 'Yes' or 'No'. If 'Yes', list any conditions being treated.
  5. Respond to questions regarding serious illnesses, medications, and allergies by checking 'Yes' or 'No' as applicable, providing details where necessary.
  6. Complete sections on special needs and medical history by checking relevant boxes and filling in additional information as required.
  7. Review all entries for accuracy before saving or submitting your completed form.

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All patients of record should be asked to complete a new health history form every two years. This process can greatly reduce the possibility that the patient will inadvertently neglect to advise the dentist and staff of recent changes to his/her health status.
The easiest dental schools to get into in the US, based on acceptance rates, are the University of Mississippi, the University of Minnesota, East Carolina School of Dental Medicine, the University of Puerto Rico, the University of Utah and the University of Detroit Mercy.
Our GPA averages are typically between 3.5-3.6 for the overall GPA and between 3.3-3.5 for the biology, chemistry, physics (BCP) GPA. Other DAT averages have been steady for several years: Academic Average-20, Perceptual Ability-20, Biology-19, Organic Chemistry-21, Reading-21, and Total Science-20.
In the most recent year that data is available (2021-22), 11,759 applicants applied to dental school. This is a 7% increase from the prior year.
The School of Dentistry accepts Medicare (medical only), Medicaid and KCHIP.

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The UofL School of Dentistry received an 8.94 composite score on a scale of 1-10. UofL ranked highest in career support, education quality and program value, with greater than nine-star ratings in these areas.

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Student Clinic Location - UofL Dental Care

New Patient Packet [PDF] Includes directions, parking information, health history form and more. View Document Contact us UofL School of Dentistry Student

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