Adult New Patient Medical Form - Creative Smiles 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Patient Information' section. Enter your last name, first name, preferred name, date of birth, and contact details including mailing address, home phone, work phone, cell phone, and email.
  3. Next, move to the 'Medical History' section. Circle 'yes' or 'no' for each question regarding your current health status and any medications you are taking. If applicable, provide explanations where prompted.
  4. In the 'Personal Dental History' section, answer questions about your previous dental experiences and any concerns you may have regarding dental treatment.
  5. Finally, sign and date the form at the bottom to confirm that all information provided is accurate.

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An accurate medical/dental health history is vital since it may provide valuable information for the dentist prior to beginning treatment, especially since certain medications can influence treatment decisions or may impact post-operative care instructions.
Purposes of the history: carefully prepared personal, medical, and dental histories are used in comprehensive patient care to provide information pertinent to the etiology and diagnosis of oral conditions and the total patient care plan; reveal conditions that necessitate precautions, modifications, or adaptations
It is crucial to understand past experiences in order to provide optimal care in the future. Also, this discussion might lead to identification of specific problems such as areas of food impaction, inability to floss, areas of pain, and broken restorations or tooth structure.
Teaching the history of dentistry can provide a unique lens for understanding the professionalization of dentistry, its separation from medicine, and the impact of access to oral health care.
Understanding your patients medical and dental history is crucial to providing the best service possible. These forms contain critical information like allergies, past operations, dental treatments, medical issues, and other factors that can alter treatment options.