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NowPrice:AU$9.01

Original Price: AU$12.88

30% off

•

Sale ends on 29 September

GST Included

Editable Dental Office Intake Form | Health History, Patient Registration (Word + PDF)

Includes Etsy Purchase Protection

You can only make an offer when buying a single item.

Highlights

  • Designed by TradeDocsStudio
  • Party decor for gatherings and celebrations
  • Digital download
  • Digital file type(s): 1 ZIP

Dental Office New Patient / Client Intake & Health History Form — an editable Word + PDF template built for dental practices, office managers, and front-desk teams.

This template collects registration details, practice-specific questions (insurance or treatment goals), a check-box health history, medications and allergies, current concerns, and a signed acknowledgment. Open it in Word or Google Docs, replace the bracketed placeholders with your company name, logo, prices, and terms, and it's ready to use on your next job.

★ SAVE 50% WITH THE BUNDLE ★
This template is $7.99 on its own. The Dental Office Forms Bundle gives you all 8 Dental Office templates — New Patient / Client Intake & Health History Form, Daily Opening & Closing Checklist, Appointment Confirmation, Reminder, No-Show & Recall Message Templates, Financial Policy, Treatment Consent & Photo Release, Front Desk SOP, Daily Task List & Phone Scripts, Feedback Survey & Review Request Form, Cancellation & No-Show Policy, Supply Inventory & Order Checklist — for $34.99 instead of $69.92 bought separately.
👉 Get the bundle: https://www.etsy.com/au/listing/4570467346/dental-office-forms-bundle-8-editable
👉 Or the Dental Office Complete Practice Kit — 12 templates for $69.99 (41% off): https://www.etsy.com/au/listing/4570718607

WHAT YOU GET (instant download, ZIP file)
• Editable Microsoft Word file (.docx) — US Letter
• Editable Microsoft Word file (.docx) — A4
• Print-ready PDF — US Letter
• Print-ready PDF — A4
• Quick-start README with editing instructions and license

WORKS WITH
Microsoft Word, Google Docs, Apple Pages, LibreOffice. No Canva or special software needed.

WHY THIS ONE
• Written specifically for dental office work — not a generic form with the name swapped
• Plain-language wording your customers can actually read
• Clean, professional layout with a header block for your logo and license number
• Fill-in fields, tables, checklists, and signature lines already laid out

COMPLETE YOUR DENTAL OFFICE PAPERWORK
Every Dental Office template in our shop shares the same layout, header block and wording, so your intake, estimate, invoice and agreement look like one system. Bundle: https://www.etsy.com/au/listing/4570467346/dental-office-forms-bundle-8-editable
Complete kit: https://www.etsy.com/au/listing/4570718607

PLEASE NOTE
• This is a digital download; nothing will be shipped.
• Colors may vary slightly between screens and printers.
• Templates are for use in your own business and may not be resold or redistributed.
• Not legal advice: review agreements and policies with a qualified professional and adapt to your local laws before use.
• Designed by TradeDocsStudio with the help of AI tools and reviewed by a human before listing.

Due to the digital nature of this product, refunds are not available — but if anything is wrong with your files, message us and we'll fix it.

Instant Download

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Instant download items don’t accept returns, exchanges or cancellations. Please contact the seller about any problems with your order.

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Listed on 07 Sept, 2026
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