Free template
Emergency dental appointment note template
For a patient attending in pain or after an injury: the presenting complaint, a focused examination of the tooth or site, a diagnosis, and the treatment given there and then. Built for a note written quickly between emergency patients.
PRESENTING COMPLAINT
Complaining of:
History of presenting complaint:
Assisted by:
MEDICAL HISTORY
Medical History:
Allergies:
Medications:
PMS Updated:
EXTRAORAL EXAMINATION
Temporomandibular Joint:
Muscles of Mastication:
Lymph Nodes:
Salivary Glands:
Facial Symmetry:
Lips:
INTRAORAL: SOFT TISSUE
Mucosa:
Gingivae:
Tongue:
Palate:
Floor of Mouth:
Oropharynx:
FOCUSED EXAMINATION
Tooth / Site:
Radiograph:
Radiograph Status:
Radiograph Findings:
Radiograph Grade:
Justification:
SPECIAL TESTS
Special Tests:
DIAGNOSIS
Diagnosis:
OPTIONS, RISKS & CONSENT
Options Discussed:
Estimate Discussed:
Risks and benefits discussed:
Verbal consent after discussion of treatment:
TREATMENT PROVIDED
Treatment:
Local Anaesthetic:
Post-op Instructions:
Medication Dispensed / Prescribed:
Adverse Reactions / Complications:
Review:
GDC standard 4.1 expects a patient's clinical record to be made as the appointment happens, and to be accurate and complete.
How Assist helps
Assist fills this in for you.
Assist records the appointment and drafts a note in this structure for the dentist to review and sign off. It writes up what was said in the room, and you check every line before it goes in the record.
28 days free. No card required.
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