Market Place Dentistry Medical History Form Please - marketplacedentistry co 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information, including your name, date of birth, address, and contact details. This section is crucial for identifying you as a patient.
3. Indicate whether you are currently receiving treatment from any healthcare provider. If yes, provide further details about your doctor and their practice.
4. Answer the medical history questions regarding medications, treatments, allergies, and past medical conditions. Be thorough in your responses to ensure accurate care.
5. Complete the social history section by detailing your alcohol consumption and smoking habits. This information helps your dentist understand your overall health better.
6. Finally, indicate who completed the form (yourself, parent, or guardian) and sign with the date to validate the document.

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