Dental Forms and Documents to
Download or Print

These documents have come from individuals who want to share with the dental community, are not copyrighted and were freely available without restrictions for use. Please contact me if you have material you would like to contribute, or if you know of any copyright issues with any of the content.

Dental Office Management

• Job Applications
  • Employment Application 1
  • Employment Application 2
  • Employment Application 3 - from Chamber of Commerce;
• Office Policy Manuals
  • Sample Office Employee Handbook
  • Computer Use Policy
• Employment Forms
  • Download Form I-9, English
  • Download Form I-9, Spanish
  • U.S. Citizenship and Immigration Services - About Form I-9
  • Download Form W-4
• Employee Performance Review forms
  • Performance review form 1
  • Performance review form 2
  • Employee Record of Disciplinary Action
• Office Team Management
  • "Want To Be Liked? Guard Against These Faults"
  • "As A Professional Team Player, I Will..."
  • "Attributes For A Winning Personality"
  • "Why Patients Change Dental Offices"
• HIPAA
  • Notice of Privacy Practices
  • Employee Confidentiality Agreement
  • Non-Employee Confidentiality Agreement
  • Patient Request to Correct or Ammend Record
  • Patient Request to Revoke their Authorization
• Miscellaneous
  • Embezzlement and Theft Prevention
  • Estate Planning For Dentists (and everyone else)
  • Request for Time Clock Adjustment
  • Fix-It List
  • X-ray Viewbox Simulator (PowerPoint) - Turn your screen into an x-ray viewbox by using a PowerPoint program.

Handouts and Information for Patient

• Post-Op Instructions
  • Implant Placement
  • Bone Graft
  • Sinus Lift
  • Gingival Graft
  • Perio Surgery
  • Extraction
  • Scaling and Root Planing
  • Scaling and Root Planing
  • Arestin
  • Arestin
  • Crown and Bridge
  • Patient Self-Care Recommendation form
• General Dental Information
  • Dry Mouth/Xerostomia
  • Dry Mouth/Xerostomia
  • Gum Recession illustration
  • Propylactic Cardiac Premed
  • Joints Premed
  • Instructions for Dental Infections
  • Instructions for Dental Infections
  • Lichen Planus
  • Lichen Planus
  • Sinus infection Instructions
  • Smoking Cessation
  • Cavity-Free Checkups
  • Cold Sore Products
  • Denture Cleaning
  • Mouthwashes Without Alcohol
  • Mouthwashes Without Sodium Laurel Sulfate preservative
  • Toothpastes Without Sodium Laurel Sulfate
  • Sugarfree Gum
  • Sugarfree Cough Drops
  • Dental Products containing Xylitol
  • How To Have Cavity-Free Check-ups
• Administrative
  • Notice to Medicare Dental Patients
  • Policy on No Shows and Cancellations
  • Summary of Patient Record for patient transferring to new office
  • Statement of Account Delinquency
  • Refusal to Disclose Social Security Number
  • Fee Estimate worksheet
  • Procedure Routing Slip
  • Medical Consultation Form
  • Turn Off Mobile Phones sign for operatories
  • Laser Danger warning sign

Consent Forms

• Implants 1
• Implants 2
• Sinus Lift
• Gingival Augmentation
• Periodontal Therapy
• Scaling and Root Planing 1
• Scaling and Root Planing 2
• General Consent 1
• General Consent 2
• General Consent 3
• Financial Liability Release
• Photography Use
• Apicoectomies and Apical Surgery
• Bisphosphonate
• Composite Fillings
• Silver Amalgam Fillings
• Amalgam Replacement
• Crown and Bridge
• Posts and Pins
• Dentures 1
• Dentures 2
• TMJ Therapy
• Splint Treatment
• Cosmetics 1
• Cosmetics 2
• Endodontics 1
• Endodontics 2
• Endodontics 3
• Endodontics 4
• Endodontics 5
• Endodontics 6
• Endodontics 7
• Endodontics 8
• Endodontics 9
• Endodontics 10
• Endodontics 11
• Endodontics Retreatment
• Pulpotomy
• Orthodontics 1
• Orthodontics 2
• Oral Surgery 1
• Oral Surgery 2
• Oral Surgery 3
• Oral Surgery 4
• Oral Surgery 5
• Oral Surgery 6
• Oral Surgery 7
• Oral Surgery 8
• Oral Surgery 9
• Oral Surgery 10
• Oral Surgery 11
• Oral Surgery 12
• Extraction 1
• Biopsy, including biopsy refusal
• Periodontal Crown Lengthening Surgery
• Nitrous Oxide
• IV Sedation 1
• IV Sedation 2
• Photography Release

Health History Forms

• Patient Information/Registration/Health Hx form #1
• Patient Information/Registration/Health Hx form #2
• University of the Pacific forms in multiple languages
  • English
  • Arabic
  • Chinese
  • French
  • German
  • Italian
  • Japanese
  • Korean
  • Polish
  • Russian
  • Spanish
  • Vietnamese
• University of Washington Medical and Dental History

Clinical Charting Forms

• Periodontal Chart, blank
• Periodontal Chart 2, blank
• Tooth Chart diagram, adult  -- for making your own form
• Tooth Chart diagram, child -- for making your own form
• Charting Oral Pathologies
• Charting extraoral head and neck pathologies
• Charting intraoral and extraoral head and neck pathologies
• Exam charting form, front
• Exam charting form, back
• Exam charting form (same as two above, but in one pdf file)
• Radiographic Exam Form
• Recare Exam form
• Treatment Plan worksheet
• Treatment Plan worksheet with tooth chart
• Treatment/Progress Notes
• Periodontal Disease Report to customize for a patient
• Periodontal Disease Report
• Nitrous Oxide N2O Progress Note

Reference Documents

• Panoramic Radiography Tips - good reference for staff; from Kodak
• Intraoral Radiography Tips
• Average Tooth Dimensions chart

Other sources for dental forms

• Case Western Reserve clinic forms
• University of Minnesota patient forms
• UCSF new patient forms

 

Other Pages for Dental Professionals on this website:
Where to next? ... Business Management Resources Downloads Sample Letters Clinical Resources

 

- Indicates a PDF file
- Indicates a link to an external website
- Indicates a Microsoft Word file
- Indicates a Microsoft Publisher file

© Copyright 2008-2012 by Dr. Randall Otterholt, All rights reserved