Medical History Form

A patients’ medical history enables the dentist to obtain information necessary to provide safe and individualised care. It is for your safety and as part of the Australian Dental Regulations that a thorough medical history is taken. A medical history helps to identify conditions relevant to your dental health or which could have an impact on how the treatment is carried out.

You must tick (Yes or No) for each of the conditions listed on the form. You must note any and all allergies, other conditions not mentioned, and ALL medications.

Under the Australian Dental Association, we are required to have an updated medical history every 12 months, this means we print out the medical history you filled out last time and ask you to check over it and make any changes and resign it.

Please be assured that all information is kept strictly confidential and is not used outside the dental office without your permission.

If you have any questions please don’t hesitate to call and speak to our friendly staff.

Common medications the dentist needs to know you are taking

Of particular importance to the medical history is a list of any medications a patient is currently taking. These may include drugs prescribed by a doctor or specialist as well as those purchased over the counter. Many medications when combined can interact and reduce the efficacy of other medications which may be prescribed by your dentist. They may also indicate an underlying condition not previously noted.

Please note that your dentist may not be able to proceed with a dental treatment if he/she does not have your relevant medical history. You may be required to come back for the next appointment when the medical history form is fully completed. Your health and safety is paramount to us.