Dental Patient Information Form Template

About this template

A dental patient information form is used by dental practices for collecting information about patients before the appointment. This Dental Patient Information Form allows new patients to enroll your database by providing their personal and contact information, dental insurance details, health information with further details. A dental patient information form is an essential part of any checkup, ensuring that patients provide the most accurate information about their dental history. Previously, this type of form was typically filled out by hand, which meant lots of copying and pasting from previous visits. Now, it can be easily and quickly completed online.

Create an online form with your logo, change colors and fonts, add a new background image, or add other widgets to customize the form to your needs. You can even automatically email submissions to yourself for quick processing, or turn them into PDFs for download or printing. If you’d like to add patient responses to your other accounts — like Google Drive, Dropbox, or Box — do so with Jotform’s 100+ integrations.