formisoft

Dental History Form

Asks about last dental visit date, prior dental treatments, and periodontal health history. Built for general dentistry new patient intake documentation.

Questions
12
Pages
2
Time
about 3 min

Includes

  • E-signature
  • Medication list
  • Conditions checklist
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Your practice

Dental History Form

Page 1 of 2 · Your information

Live preview. Tap through it like a patient.

Who it is for

  • General dentistry new patient intake documentation
  • Periodontal practice comprehensive assessment
  • Oral surgery pre-operative history collection
  • Orthodontic treatment planning and records transfer

Formisoft for Dental

What's inside

Page 1 · Your information

  1. Full NameText · Required
  2. Last Dental Visit DateDate
  3. Prior Dental TreatmentsLong Text
  4. Periodontal Health HistoryConditions
  5. TMJ/TMD SymptomsLong Text

Page 2 · Additional details

  1. Oral Hygiene RoutineLong Text
  2. Dental Anxiety LevelMultiple Choice · 4 choices
  3. Bruxism/Nightguard UseLong Text
  4. Relevant Medical ConditionsConditions
  5. Current MedicationsMedications

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Dental History Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 12 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Dental History Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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