01395 263 225
General & Specialist Dentistry

Medical History Form

All patients will be required to fill in the medical history form at every examination appointment as it is required by the General Dental Council.

It is important that we have up to date records of your contact and medical information before we can complete your routine examination. We are required as a dental practice to ensure that we have the most up to date information on our records. A lot can happen in the 6-12 months between check ups and we require it to be filled in every time as it is legally required.

Unfortunately writing "No Change" will not be accepted.

Pen and Paper