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Tooth whitening note template
For a tooth whitening assessment or review: suitability, starting shade, the product and method used, and the instructions given to the patient. Covers both an in-surgery and a take-home whitening case.
PRESENTING COMPLAINT
Reason for Visit:
Assisted by:
MEDICAL HISTORY
Medical History:
Allergies:
Medications:
PMS Updated:
ASSESSMENT
Suitability:
Starting Shade:
Sensitivity History:
OPTIONS, RISKS & CONSENT
Options Discussed:
Estimate Discussed:
Risks and benefits discussed:
Verbal consent after discussion of treatment:
TREATMENT
Product:
Method:
Instructions:
REVIEW
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.
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