Dental Treatment Record
Progress Notes

Essential for treatment documentation

"Endorsed by the Colorado Dental Association"

Progress notes are a vital part of any charting system. They are the legal record of what has transpired with a patient.

With this form, document:

• Anesthetic - type, number of carpules, etc.

• Nitrous Oxide / Oxygen Percentages

• Complications

• Informed consent

• Phone discussions with patient, specialists or physicians

• Complete description of all treatment and any extenuating circumstances

• Provider Signature

Everything that occurs with a patient must be written down. If corrections need to be made, make a single line through the incorrect entry. No erasure or "white out" should be used. An optional consideration is the Piggyback System ( C-301R and C-401R)

FORM FEATURES

• Date of treatment 
• Auxiliary - name or initials
• Tooth or quadrant
• Surfaces
• Services description
• Provider signature
• ADA Code - allows for proper billing and insurance coordination
• Fee for procedure

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Sample Form in PDF format

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Privacy Policy

Stepping Stones to Success is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing dental education programs of this program provider are accepted by the AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 8/1/2009 to 7/31/2012.