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Essential Elements of a Medical History Form


May 16, 2022




Want to be certain that your Medical history forms are following required guidelines? Find out why medical history forms are important, and what essential elements must be included.

Why is a Medical History Form Needed?

Dentists and Healthcare professionals must know the medical background of a patient prior to proceeding with an examination. Without having important knowledge in advance, like pre-existing health conditions or allergies, undesired outcomes may arise later that can lead to legal repercussions.

Let’s discuss the elements of a Medical history form, and what should be included.

Elements of a Medical History Form

Medical History Form

Medical history forms are composed of sections to gather vital patient information. Below are 3 important elements of the medical history form that practices will want to collect for each patient:

  • Patient’s Information 
  • Health & Medical History
  • Family Medical History

Patient’s Information

Patient’s information provides the practice with a profile to ensure general data is on file about the patient. Important information includes:

  • Patient’s Name
  • Guardian’s Name (if applicable)
  • Home address 
  • Birth Date
  • Emergency contact 
  • Phone number 
  • Email address
  • Marital and employment status

Health and Medical History

The health and medical history portion includes details about any previous or existing health or medical issues. The following information is collected, as it may be pertinent for a dentist or healthcare professional to be aware of prior to the exam:

  • Medications the patient is currently taking or has recently stopped
  • Allergies (food, medication, material, etc.)
  • Previous or existing health or medical conditions
  • If currently under care of a physician
  • Previous injuries 
  • Past hospitalizations or operations
  • Substance or tobacco use

Family Medical History

Family Medical History

Family medical history provides important details about family members with conditions, like diabetes or heart disease. Genetics can play a large role in determining a patient’s diagnosis, and helps dentists and healthcare professionals know what conditions to keep an eye out for.


Medical history forms are an essential part of the intake process in any dental or healthcare practice. Knowing a patient’s pre-existing health and medical conditions, medications, allergies, etc, is important before the exam. Collecting pertinent information on the medical history form is easier when done digitally, syncing into your practice management software (PMS).

Find out how mConsent’s paperless forms simplify the process, improving accuracy, efficiency, and integrating into your PMS.

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