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Implant consultation note template
For an implant assessment or consultation: the site and bone, risk factors considered, the options discussed and the plan agreed. Covers the consultation stage, not the surgical placement itself.
PRESENTING COMPLAINT
Reason for Visit:
Assisted by:
MEDICAL HISTORY
Medical History:
Allergies:
Medications:
PMS Updated:
SOCIAL HISTORY
Smoking:
Cigarettes per Day:
Years of Smoking:
Previous Cigarettes per Day:
Previous Years of Smoking:
Vaping:
Vaping Details:
Alcohol:
Stress:
IMPLANT ASSESSMENT
Site:
Ridge / Bone:
Imaging:
Imaging Status:
Justification:
Radiograph Grade:
Radiograph Findings:
Risk Factors:
OPTIONS, RISKS & CONSENT
Options Discussed:
Estimate Discussed:
Risks and benefits discussed:
Verbal consent after discussion of treatment:
PLAN
Options Discussed:
Plan:
Next Visit:
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.
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