What is the reason for your visit?
When was your last dental visit?
How often do you have dental cleanings?
Have you ever been told to take a pre-medication prior to dental treatment?
How often do you brush your teeth?
How often do you floss your teeth?
What other dental aids do you use?
Have you ever had:
If "yes", please share what type of dental appliance.
Have you experienced:
Are you satisfied with your teeth's appearance?
Do you feel nervous about having dental treatment?
Is there anything else about having dental treatment that you would like us to know?
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