The Complete Dental System
Our popular, preassembled chart contains all the necessary forms a dental
office needs, and costs less than purchasing each separately.
Each preassembled chart includes:
• Durable 11pt pocket folder (#MPFA-10) with 2" bonded
fastener; an MSDA-11 file divider with a twin prong fastener;
and a 5-mil poly pocket 8-3/4" W x 5-1/2" H.
• Eight (8) clinical forms
Patient Registration – (27000)
gathers complete personal, billing,
and insurance information.
Recall Examination – (27002)
updates health information, exam history,
x-ray history, hygiene instructions
and more at subsequent visits.
Progress Notes –
(27003)
columns record tooth, anesthetic given
and treatment documentation. 2 sides.
Health History Update – (27004)
documents changes in health or medication.
Correspondence Log – (27006)
tracks correspondence sent or received
by the office.
Clinical Examination – (27007)
documents patient’s first visit, including chief
complaint and existing or previous condition.
Treatment Plan with Chart –
(27009)
records
exam on a diagram with additional
space to document treatment plans and
completion dates.
Health History–
(27011)
detailed medical and dental condition
questions, previous dental treatments
and more. 2 sides.
26999 - Complete Chart
(25 / box)
26998 - Dental Records Folder - No Forms
(25 / box)
Individual forms are also available in packages of 100.
27000
(100/pkg)
27002
(100/pkg)
27003
(100/pkg)
27004
(100/pkg)
27006
(100/pkg)
27007
(100/pkg)
27009
(100/pkg)
270011
(100/pkg)
Preassembled
DENTAL System
MAKES YOUR PRACTICE
MORE EFFICIENT!
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