This colorful, patient-friendly form captures personal, insurance, dental, and medical history in one convenient two-sided layout. Printed on durable 28-pound ledger stock and sized at 8 1/2 x 11 inches, each pad includes 100 forms—ideal for high-volume dental offices.
Made with pride in USA
ABC Two-Sided Registration & History Form, Dental Icon Design, 28# Ledger
Price range: $246.00 through $1,019.00
- Two-sided format – Front captures personal and insurance info; back covers dental and medical history
- Dental icon design – Colorful, patient-friendly layout creates a welcoming experience
- Comprehensive sections – Includes fields for contact details, insurance, dental visits, medications, and benefit assignment
- Standard letter size – 8 1/2 x 11 inches for easy filing and clipboard use
- Durable 28# ledger stock – Built to last through frequent handling
- High quantity – 100 forms per pad for busy dental practices
- Made with pride in USA
| Quantity | 5, 10, 20, 35 |
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