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Health History - 4054


In Store Price: $52.25
Your Online Price: $41.85
You Save Online: $10.40 (20 %)
These proven forms capture patient health history quickly & comprehensively! Questionnaire covers both dental & medical information.
  • Please note: No-hole punch.
  • Simple checklist format. Forms use a series of questions designed to prompt responses through a simple checklist format.
  • Double-sided. Printed on 2 sides on white ledger stock.
  • Easy to read. Dentist can quickly scan the completed form & identify problem "yes" areas to discuss with the patient
Item Number: 04-4054

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