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Dental health history questionnaire

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Dental health history questionnaire

How often do they really floss, and what’s up with that old filling? Get all the answers with this easy questionnaire.

Collect up to 3.5x more data with Typeform

Find out if they really floss, once and for all.

Is everyone completely honest at the dentist when you ask them about hygiene habits and the last time they came in? Make it easier for patients with this questionnaire. They can give you all the info you need in the time it takes them to brush their teeth.

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Dental health history questionnaire FAQs:

Does your patient admin need a cleaning? Polish it up with this dental health history questionnaire. You can automatically create patient files from every response that comes in, without having to pick information out of spreadsheets. All thanks to smart integrations with tools like Google Docs and Office 365.

Well, you won’t want to wait until your tools are already in their mouth. Send this dental health history questionnaire ahead of every first appointment intake, so you and your patients show up well-prepared. You’ll know what to expect when they arrive, and they have time to think about how long they really brush their teeth for.

Before you send out your form, there are two things you should do:

  1. Set up a BAA (Business Associate Agreement) with us

Typeform is a HIPAA-compliant company, so all the healthcare-related info you process with us is legally airtight. But for you to be 100% HIPAA compliant, you’ll first need to set up a BAA. To do this you would need to talk to us about our enterprise plan, which you can do by filling out this Typeform, or contacting your Typeform account manager.

  1. Check the local data collection laws

Data collection laws aren’t a one-size-fits-all thing—especially when there’s sensitive medical info involved. So before hitting share, seek advice from a local lawyer to make sure you’ve covered everything.

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