Health questionnaire children

This questionnaire is important for both the dentist and your child. The dentist needs to know if there are any health issues that might give complications during a treatment. 

Please fill in the questionnaire before your child's first visit in our practice or if anything has changed in the health of your child. 

Questions with *  are mandatory to fill in.

You can send it directly by pushing  the "Send" button, or you can print it and take it with you when you visit our practice. 

We will treat the data you send to us confidentially, and these are covered by medical professional secrecy.