Get Anamnesis Questionnaire

Completing the Anamnesis Questionnaire online is an important step in providing detailed health information about your child. This guide will walk you through each section of the form to ensure that you accurately fill out all required fields.

Follow the steps to complete the Anamnesis Questionnaire.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin with the personal information section. Input the child's family name, first name, date of birth, and place of birth. Ensure you specify the legal guardian's information by selecting the appropriate option: both parents, mother, or father.
3. Continue with the parents' contact details. Fill in the family name, first name, date of birth, email, street, postcode/city, telephone, and mobile number. Choose the correct options for each parent regarding insurance coverage.
4. Complete the health insurance section by entering the name of the insurance company and any additional insurance details if applicable. Specify if the child is insured with the mother or father.
5. Move to the general health questions section. Answer each question regarding allergies, respiratory diseases, blood coagulation disorders, and other health conditions by selecting 'Yes' or 'No' as applicable. Make sure to note any relevant conditions or medications.
6. Proceed to the dental health questions. Indicate whether the child has visited a dentist, their attitude towards dentists, any current toothache, and any dental accidents. Provide information on achievements in orthodontic treatment if relevant.
7. In the nutrition & brush habits & fluorid anamnesis section, provide detailed answers about breastfeeding, bottle feeding, types of beverages consumed, frequency of sweets consumption, and brushing habits.
8. Fill in the anamnesis of the parents by addressing their allergies and any tendencies towards dental issues like caries or calculus.
9. Finally, answer the general questions section. Indicate how you learned about the practice and whether you agree to receive appointment reminders.
10. After completing all sections, review your entries for accuracy. You can save changes, download, print, or share the completed form as needed.

Take the first step and complete the Anamnesis Questionnaire online today.