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Report Attach Detach

Case Presentation

Dental Report Card

Patient	:
Date	:

Patient report

General Dental Assessment

Which of these are present?:

Periodontal "Gum" Health

Inflammation

Mild

Moderate

Severe

Calculus / Tartar

Mild

Moderate

Severe

Recession

Mild

Moderate

Severe

Joint Health (TMJ) Exam

Crepitus / Clicking / Popping

Clenching / Grinding

Pain

Oral Cancer Screening

Negative (No Findings)

Treatment recommendations including Referral Notes

Case Presentation Dental Chart

Tooth no.	Existing Condition of teeth	Suggested Treatment
#	Description :	Description :

Perio Chart

Upper Facial

Mobility
CAL
FGM
MGJ
Furcation
Suppuration
Bleeding
Pocket Depth
Tooth No

Maxillary

Upper Lingual

Tooth No
Pocket Depth
Bleeding
Suppuration
Furcation
MGJ
FGM
CAL
Mobility

Lower Lingual

Mobility
CAL
FGM
MGJ
Furcation
Suppuration
Bleeding
Pocket Depth
Tooth No

Mandibular

Lower Facial

Tooth No
Pocket Depth
Bleeding
Suppuration
Furcation
MGJ
FGM
CAL
Mobility

X-ray & images

()

Patient Name:
Tooth#:
Note:

Date:

Uploads

Date :

Notes :

Treatment History

Date	Treating Provider	Location	Form	Type	Code	Description	Tooth	Surface	Quadrant	Fee

Treatment Plans

Diagnosis Date	Tr ID	Phase ID	Order ID

Treatments:

Date	Treating Provider	Location	Form	Type	Code	Description	Tooth	Surface	Quadrant	Fee

No treatments selected

Progress Notes

Date of Service:

Education

Selected Education

Remove

No education selected

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Medical Reports

Actions

Schedule Appointment

1. Video call

2. 6 Month Recall

3. 3 Month Recall

4. Referred To

Patient Name :
Phone Number :
Email :
Attachments :	Attach Files (Attach new patient medical history, forms, uploads, case presentation & report cards, xrays) (Attach new patient medical history, forms, uploads, dental charting & report cards, xrays)

Patients

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Report Attach Detach

Case Presentation

Dental Report Card

Patient report

General Dental Assessment

Periodontal "Gum" Health

Joint Health (TMJ) Exam

Oral Cancer Screening

Treatment recommendations including Referral Notes

Case Presentation Dental Chart

Perio Chart

X-ray & images

Uploads

Treatment History

Treatment Plans

Treatments:

Progress Notes

Education

Selected Education

To access more feature, Subscribe to pro.

Medical Reports

Actions

Schedule Appointment

doc4 Khan

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Attached Forms

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Responsible Party Info

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