Dental New Patient Form
What a dental new patient form asks, why each part matters, and how dental practices collect it.
A dental new patient form records who the patient is, their insurance, an emergency contact, and the dental and medical history a practice needs before the first visit. It's also called a new patient information form or a patient information sheet.
Dental new patient form, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a dental new patient form in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample dental new patient form questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- What is your date of birth?Patient details
- How would you like us to contact you?Patient details
- Do you have dental insurance?Insurance
- Who is the policy holder?Insurance
- Who should we call in an emergency?Emergency contact
- How is that person related to you?Emergency contact
- What is the reason for your visit today?Dental history
- When was your last dental visit?Dental history
- Are you under a physician's care?Medical history
- Do you take any medications?Medical history
- Do you use tobacco?Habits
- Do you grind or clench your teeth?Habits
These are examples to read, not a form to fill in.
Dental new patient form: FAQ
What does a dental new patient form ask?
A typical one covers six areas: patient and contact details, dental insurance, an emergency contact, dental history, medical history, and habits such as tobacco use or grinding.
Who fills in a dental new patient form, and when?
The patient, or a parent for a child, before the first appointment. Practices may send it ahead of the visit or hand it out at check-in.
Is it the same as a patient information sheet?
The names overlap. A patient information sheet can be only the registration part: name, contact details, insurance, and emergency contact. A dental new patient form also adds the dental and medical history.
Is there a dental new patient form template?
The American Dental Association sells patient health history forms through its online store, which cover the health part only. The sample questions on this page show a typical set for the whole form.
Why does the practice ask for insurance and a policy holder?
The front desk checks coverage before treatment and sends claims to the right plan. The policy holder may be a spouse or parent, not the patient.
What happens after the form is completed?
Staff enter the registration details and check the insurance. The dentist reads the health answers before the exam and asks about anything that could affect care.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
