DENTAL PATIENT COMMUNICATION CHECKLIST: PRE-APPOINTMENT & FOLLOW-UP

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--- PRE-APPOINTMENT COMMUNICATION ---
[ ] Appointment Date
[ ] Appointment Time
[ ] Reason for Visit (Exam, Cleaning, Restoration, Consultation)
[ ] Special Instructions/Concerns
[ ] Insurance Provider (Delta Dental, Cigna, Aetna, No Insurance)
[ ] Insurance Card (Front)

--- APPOINTMENT REMINDERS ---
[ ] Number of Reminders Sent
[ ] Reminder Method (Email, Text, Phone) (Email, Text, Phone)
[ ] Reminder Sent Date
[ ] Reminder Sent Time
[ ] Reminder Status (Sent, Delivered, Read) (Sent, Delivered, Read)
[ ] Opt-Out Status (Opted In, Opted Out)

--- PRE-APPOINTMENT INSTRUCTIONS ---
[ ] Specific Fasting Instructions (if applicable)
[ ] Medication Restrictions/Guidelines
[ ] Allergy Information Reminder
[ ] Transportation Arrangement Confirmation (e.g., driver) (Confirmed, Not Confirmed, N/A)
[ ] Review of Consent Forms (Reviewed and Signed, Not Reviewed, N/A)
[ ] Appointment Date Confirmation
[ ] Appointment Time Confirmation

--- ARRIVAL & CHECK-IN ---
[ ] Patient Arrival Time
[ ] Check-in Method (Online Portal, Phone Call, In-Person)
[ ] Patient Signature Verification
[ ] Insurance Card Scanned? (Yes, No)
[ ] Wait Time Before Appointment Start
[ ] Notes on Arrival/Check-in

--- POST-APPOINTMENT INSTRUCTIONS ---
[ ] Detailed Post-Operative Instructions
[ ] Prescription Refill Quantity (if applicable)
[ ] Follow-up Appointment Date (if scheduled)
[ ] Time of next medication dose (if applicable)
[ ] Pain Management Options Discussed (Over-the-Counter Pain Relievers, Prescription Medication, Ice Pack Application, Other (Please Specify))
[ ] Dietary Restrictions Explained? (Yes, No)
[ ] Any specific concerns or questions from the patient?

--- FOLLOW-UP COMMUNICATION ---
[ ] Date of Follow-up Call/Email
[ ] Method of Follow-up (Phone Call, Email, Text Message)
[ ] Number of Attempts to Contact
[ ] Notes from Follow-up Communication
[ ] Patient Reported Status (Recovering Well, Experiencing Complications, Satisfied, Unsure)
[ ] Action Taken (e.g., Referred to Specialist)
[ ] Date of Next Follow-up (if applicable)

--- FEEDBACK & SATISFACTION ---
[ ] Overall Satisfaction (1-10)
[ ] How would you rate the cleanliness of the office? (Excellent, Good, Fair, Poor)
[ ] How would you rate the friendliness of the staff? (Excellent, Good, Fair, Poor)
[ ] What did you like most about your experience?
[ ] What could we have done to improve your experience?
[ ] Which of the following best describes your reason for visiting? (Routine Check-up, Cleaning, Restorative Treatment, Cosmetic Treatment, Emergency)

--- RECALL & REAPPOINTMENT SCHEDULING ---
[ ] Next Recall Date
[ ] Recall Method (Phone Call, Email, Text Message, Postal Mail)
[ ] Months Until Next Recall
[ ] Type of Next Appointment (Hygiene, Restorative, Consultation, Other)
[ ] Proposed Reappointment Date
[ ] Notes about Reappointment

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