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Item#: 4046V 

  • Size: 8 1/2" x 11"
  • Min/QTY: 250
  • Price: $94.08
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Cost:
$94.08
Product Cost:
$94.08

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Health history questionnaire allows you to quickly obtain comprehensive dental & medical information.

  • Includes: 2-hole punch with check-off boxes.
  • Double-sided. Printed on 2 sides on white ledger stock.
  • Easy to read. Dentist can quickly scan the completed form & identify problem "yes" areas to discuss with the patient.
  • Simple checklist format. Forms use a series of questions designed to prompt responses through a simple checklist format.

Size: 8 1/2 x 11"

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