Dentistry exam
What are on information gathering forms -
✔1. Patient registration form - includes patient demographics which contains PHI
(Protected Health Information). This is mandated by the Health Insurance Portability
and Accountability Act (HIPAA)
3. Medical and dental health history form- Should be updated at each visit and initialed
by the patient
4. Medical Alert information- typically includes allergies, adverse reactions to drugs,
heart related conditions, Dental Anxiety, Pre-Medication or anything that may be life
altering if forgotten at the dental visit
5. Consent forms
What is informed consent forms? -
✔This form, related to a specific treatment or procedure, provides the patient with
the expected outcomes of treatment and describes any possible complications that
might occur
What is a progress note? -
✔At the conclusion of a procedure, the details of what was accomplished will be
entered in the "Progress Notes" section. Include information about the patient's:
- vital signs
- scheduled treatment for the day
- the procedure performed with the tooth number and surface related to the procedure.
What is included in a progress note? -
✔Treatment is recorded in this section of the patient record and should always
include:
- Date
- Tooth number
- Completed treatment
- Signature
-communication with the patient
What 3 documents do the dental team need before patient is treated? -
✔-Patient registration
-medical history
-informed consent
What completes a medical-dental history form? -
✔Signature and date
What forms do new patients complete? -
✔-new patient forms
-medical history
-informed consent
why patients seek dental care -
✔-As a new patient to begin dental care
