Anamnesis form

Health questionnaire

The anamnesis form gives the dentist insight into your general health, medication use, disorders and allergies. This allows us to offer customized care and to act in the right way if you experience problems with your health during your visit to the practice.

If you have difficulty filling in the form or have questions, you can always contact us (option 1).

Of course, the completed anamnesia form is securely documented in the (digital) patient file and we handle your data securely as described in the privacy statement.

Personal data

6.1 If so, what is your blood pressure?
We only use personal data that you provide to provide you with the best possible service. See also our Privacy statement. By clicking on 'send' you agree.
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