Free dental form templates

Free dental forms for your practice

Sample medical history, consent, new patient and patient feedback forms. Add your practice name, preview the form, then download it as an editable Word file or print it.

Choose a formSee it as a digital form

Free to use. No sign-up needed.

Dental practice forms

Pick a form and add your practice name

The preview updates as you type. Download the Word file to change any wording, or print it straight away.

Choose a form

Sample wording only, not legal or clinical advice. Adapt it to your practice and check it with your clinical team and professional adviser before you use it with patients.

Preview

Your practice name

Sample

Medical History Form

Please complete this form before your appointment. Your answers help us plan safe treatment. Tell us if anything changes.

Your details

Full name:
Date of birth:
Phone number:
GP name and surgery:

Medicines and allergies

  • Are you taking any medicines, including inhalers, blood thinners or bisphosphonates?YesNo
  • Do you have any allergies, for example to penicillin, latex or local anaesthetic?YesNo
If yes, please give details

Your health

Do you have, or have you had, any of the following?

  • Heart problems, high blood pressure or a pacemakerYesNo
  • DiabetesYesNo
  • Asthma or other breathing problemsYesNo
  • Epilepsy or seizuresYesNo
  • A bleeding disorder or easy bruisingYesNo
  • Liver or kidney problemsYesNo
  • An infectious condition we should know aboutYesNo
  • Radiotherapy or chemotherapy, now or in the pastYesNo
  • Are you pregnant or breastfeeding?YesNo
  • Do you smoke or vape?YesNo
Anything else we should know?

Declaration

I confirm this information is correct to the best of my knowledge. I will tell the practice if my health or medicines change.

Patient signature
Date

Sample template from Medicasimple. Adapt it to your practice before use.

From paper to digital

The same form, without the clipboard

In Medicasimple you build each form once. Patients complete it on their phone before the visit, and the answers are saved to their patient record.

  1. 1Build it onceCreate medical history, feedback and consent forms in Settings. Paste in your own wording and use tick boxes, short answers, ratings, dates and a signature field.
  2. 2Send a secure linkSend the form to the patient by SMS, or open it on a tablet at reception for them to complete.
  3. 3Answers go to the recordCompleted forms are saved in the patient profile. Selected answers can update the patient's details for you.
  4. 4Consent you can trackConsent forms are linked to the treatment plan. See which are still pending, and when each one was approved.
  • Sent by SMS
  • Signed on the patient's phone
  • Saved to the patient record
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About these forms

What each dental form is for

Dental medical history form

Collects the health information your team needs before treatment: medicines, allergies and conditions such as diabetes or a bleeding disorder. Many practices ask patients to review it at each check-up.

Dental consent form

Records that the patient understood the proposed treatment, its benefits, risks, alternatives and cost. The form supports the consent conversation with the dentist. It does not replace it.

New patient form

Gathers contact details, an emergency contact and GP details, plus how the patient prefers to receive appointment reminders.

Patient feedback form

A short set of ratings and one open question, so you can see how visits feel and what to improve next.

Questions

Dental form templates: common questions

Are these dental forms free to use?

Yes. You can download, print and adapt them for your practice. No sign-up is needed.

Can I change the wording?

Yes. Download the Word file and edit any question or paragraph so it matches how your practice works.

Can I use the forms exactly as they are?

They are general samples, not legal or clinical advice. Review the wording with your clinical team and your professional adviser before you use it with patients.

How do patients fill in these forms digitally?

In Medicasimple you send the form by SMS. The patient completes it on their phone and it is saved to their patient record. You can also open a form on a tablet at reception.

Can I still print a form from Medicasimple?

Yes. You can print a consent form for a patient to sign on paper, and approved forms can be opened from the patient profile and printed.

Digital forms

Stop chasing paper forms at reception

Try Medicasimple free for 14 days. Build your forms once, send them before the visit and keep every answer in the patient record.

Start free trial
See digital forms

No credit card required.