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Health History - 4046V

In Store Price: $91.25
Your Online Price: $83.25
You Save Online: $8.00 (9 %)
Health history questionnaire allows you to quickly obtain comprehensive dental & medical information.
  • Easy to read. Dentist can quickly scan the completed form & identify problem "yes" areas to discuss with the patient.
  • Simple checklist format. Forms use a series of questions designed to prompt responses through a simple checklist format.
  • Includes: 2-hole punch with check-off boxes.
  • Double-sided. Printed on 2 sides on white ledger stock.
Item Number: 04-4046V

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