2022/2023 Practice Marketing & Office Supplies Catalog - 146

CLINICAL FORMS
EXAM & RECORD FORMS
(367-4678)
Back
Patient Registration (369-0023)
Recall Examination (369-0025)
Vertical
ANATOMIC EXAM RECORD FORM
* The front of this 2-sided form features " 1-32 " numbering, " a-t " lettering, and
an area to summarize patient history
* Choose from 2 formats: vertical for file folders or horizontal for file
envelopes
* 81
⁄2
* 11 " W x 81
Specify:
Vertical
" W x 11 " H vertical
⁄2
" H horizontal
Record Form250 per Pkg
(367-4678)
Horizontal
(367-3431) (Not Pictured)
Front
Progress Notes, 2-Sided (369-0026)
Health History, 2-Sided (369-0029)
EXAM/ACCOUNT RECORD FORM
* Tooth charts include " 1-32 " and " 8-1/1-8 "
adult numbering and " a-t " and " I-V/A-E "
primary lettering
* Front has areas for medical/dental history and
treatment planning
* 81
⁄2
" x 11 " vertical
(367-7525)250 per Pkg
Back
Front
Treatment Plan with Chart (369-0028)
DENTAL CLINICAL FORMS
* Maintain accurate charting and notes
* Printed on durable stock
* Formatted with vertical 2-hole punch
* 81
⁄2
" x 11 "
Clinical Forms 100 per Pkg
5 Pkg@
Specify:
Patient Registration
Recall Examination
Progress Notes, 2-Sided
Health History, 2-Sided
Treatment Plan with Chart
146
(369-0023)
(369-0025)
(369-0026)
(369-0029)
(369-0028)
EXAM RECORD TREATMENT NOTES
(369-0035)100 per Pkg
* 2-sided forms that allow for exam documentation
* Printed in black ink
* 81
⁄2
" W x 11 " H vertical
For pricing information and/or to place an order, visit: www.henryscheindental.com

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2022/2023 Practice Marketing & Office Supplies Catalog

Table of Contents for the Digital Edition of 2022/2023 Practice Marketing & Office Supplies Catalog

Contents
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