Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Dental Charting System


  • Patient Registration- gathers complete personal, billing and insurance information.

  • Recall Examination- updates health information, exam history, x-ray history, hygiene instructions and more at subsequent visits.

  • Progress Notes-columns record tooth, anesthetic provided and treatment documentation.

  • Health History Update- documents changes in health or medication.

  • Correspondence Log- tracks correspondence sent or received by the office.

  • Clinical Examination- documents the patient's first visit, including chief complaint and existing or previous condition.

  • Treatment Plan -records exam on a diagram with additional space to document treatment plans and completion dates.

  • Health History- details medical and dental condition questions, previous dental treatments and more. 


View Sample
JPEG		Recall Examination:
Printed in green ink on both sides with 2 hole punch at top and bottom to insert into a folder.

View Sample
JPEG		Progress Notes
Printed in red ink on both sides with 2 hole punch at top and bottom to insert into a folder.

View Sample
JPEG		Health History Update:
Printed 1 Side in Blue Ink, 2 Hole Punch Top

View Sample
JPEG		Clinical Examination:
Printed 1 Side in Grey Ink, 2 Hole Punch Top

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