Medical/Dental History Questionnaire

At Destination Dentistry, we are not only concerned about your dental health, but also your complete medical health and wellness. It is essential for us to have a complete record of your dental and medical history to correctly diagnose your dental concerns and design a treatment plan to best deal with those issues.

To save time on the day of your appointment, simply print and fill out the required dental/medical information and bring it with you to your scheduled appointment. If you prefer, you can set aside a few extra minutes before your appointment to complete your dental/medical history questionnaire at our office.

We look forward to meeting you!

 Click here to view form (PDF)