Medical History Form

Health Questionnaire

The medical history form gives the dentist insight into your general health, medication use, medical conditions and allergies. This enables us to provide care tailored to your needs and to respond appropriately if you experience any health problems during your visit to the practice.

Should you have any difficulty completing the form or have any questions, please feel free to contact us and select option 1.

The completed medical history form will, of course, be stored securely in your digital patient record. We handle your personal data with care and in accordance with our privacy statement.

 

Personal data
Anamnesis
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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