University of Louisville School of Dentistry Health History Form 2026

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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