Ƶ

Dental Record Form for New Zealand

Dental Record Form Template for New Zealand

A comprehensive dental record form designed for use in New Zealand dental practices, complying with the Health Information Privacy Code 2020 and relevant New Zealand healthcare regulations. This document serves as a legal record of patient information, medical history, dental treatments, and consent documentation. It incorporates essential elements required by the Dental Council of New Zealand for proper patient record keeping, including detailed treatment plans, progress notes, and medical history documentation, while ensuring compliance with privacy and health information retention requirements.

Your data doesn't train Genie's AI

You keep IP ownership of your information

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Download a Standard Template

4.6 / 5
4.8 / 5
Access for free
OR

Alternatively: Run an advanced review of an existing
Dental Record Form

Let Ƶ's market-leading legal AI identify missing terms, unusual language, compliance issues and more - in just seconds.

What is a Dental Record Form?

The Dental Record Form is a crucial document used in New Zealand dental practices to maintain comprehensive patient records in accordance with national healthcare regulations. This form is required for every patient and must be maintained throughout their course of treatment, serving as both a legal document and a clinical tool. It ensures compliance with the Health Information Privacy Code 2020, the Health Practitioners Competence Assurance Act 2003, and the Dental Council of New Zealand's requirements for patient record keeping. The form includes sections for patient information, medical history, treatment plans, progress notes, and consent documentation, making it essential for continuity of care and legal protection for both practitioners and patients.

What sections should be included in a Dental Record Form?

1. Patient Information: Basic patient details including full name, date of birth, contact information, NHI number, and emergency contact details

2. Medical History: Comprehensive medical history including current medications, allergies, chronic conditions, and previous surgeries

3. Dental History: Previous dental treatments, concerns, and oral health habits

4. Current Oral Assessment: Detailed chart of current oral condition including existing restorations, missing teeth, and periodontal status

5. Treatment Plan: Documentation of proposed treatments, priorities, and estimated costs

6. Progress Notes: Chronological record of all dental visits, treatments performed, and clinical observations

7. Consent Record: Documentation of patient consent for examinations, treatments, and information sharing

8. Payment Information: Financial arrangements, insurance details, and payment history

What sections are optional to include in a Dental Record Form?

1. Orthodontic Assessment: Specific section for patients requiring orthodontic treatment evaluation and planning

2. Pediatric Information: Additional information specific to child patients, including growth and development notes

3. Prosthetic Record: Detailed information for patients with dentures or other prosthetic appliances

4. Special Needs Assessment: Additional considerations and accommodations for patients with special healthcare needs

5. Radiograph Log: Tracking of x-rays taken and their findings

6. Sedation Record: For patients requiring sedation during treatment, including pre- and post-operative monitoring

What schedules should be included in a Dental Record Form?

1. Medical History Questionnaire: Detailed questionnaire for patient completion regarding medical history

2. Dental Charting Sheet: Visual representation of patient's dental status including tooth conditions and treatments

3. Treatment Consent Forms: Specific consent forms for various dental procedures

4. Privacy Policy Statement: Details of how patient information is collected, used, and protected

5. Fee Schedule: Current fee structure for dental services

6. Photography Consent Form: Consent for taking and using dental photographs for treatment planning and documentation

Authors

Alex Denne

Head of Growth (Open Source Law) @ Ƶ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

New Zealand

Publisher

Ƶ

Cost

Free to use
Relevant legal definitions




























Clauses




















Relevant Industries

Healthcare

Dental Services

Medical Records Management

Insurance

Public Health

Healthcare Administration

Healthcare Technology

Relevant Teams

Administration

Clinical Operations

Patient Care

Records Management

Compliance

Reception

Finance

Quality Assurance

Relevant Roles

Dentist

Dental Hygienist

Dental Assistant

Practice Manager

Dental Receptionist

Dental Specialist

Orthodontist

Oral Surgeon

Healthcare Administrator

Compliance Officer

Insurance Coordinator

Medical Records Manager

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

Find the exact document you need

Online Medical Consent Form

A New Zealand-compliant online medical consent form for documenting patient authorization for healthcare procedures and treatments.

find out more

Employee Medical Release Form

A New Zealand-compliant form authorizing the release and handling of employee medical information between healthcare providers and employers, aligned with NZ privacy laws.

find out more

Consent To Disclose Medical Information

A New Zealand-compliant legal document authorizing the disclosure of medical information between specified parties, subject to Privacy Act 2020 requirements.

find out more

Consent Form To Disclose Medical Information

A New Zealand-compliant consent form for authorizing the disclosure of patient medical information, aligned with local privacy and healthcare regulations.

find out more

Consent Form For Social (Media)

New Zealand-compliant social media consent form establishing permissions for content usage and personal information sharing across social media platforms.

find out more

Authorization Letter For Hospital Records

A legally compliant New Zealand authorization document permitting the release of specified hospital records to designated recipients under NZ privacy laws.

find out more

3rd Party Release Form

A New Zealand law-governed document that formally releases one party from claims or liabilities by another party, providing legal protection against future claims.

find out more

Authorization To Release Employment Information

A New Zealand-compliant authorization form for releasing employment information, aligned with the Privacy Act 2020 requirements.

find out more

Generic Medical Release Form

A New Zealand-compliant form authorizing the release of medical information between specified parties, adhering to NZ privacy and healthcare laws.

find out more

Inmate Release Form

A New Zealand corrections document that formally records and authorizes an inmate's release from custody, including release conditions and property return verification.

find out more

Authorization To Share Information

A New Zealand-compliant authorization template for lawful information sharing between organizations, aligned with the Privacy Act 2020.

find out more

Medical Photo Consent Form

A New Zealand-compliant consent form for obtaining patient authorization for medical photography, meeting all relevant healthcare and privacy regulations.

find out more

Authorization To Disclose Information Form

A New Zealand-compliant legal form authorizing the disclosure of personal information between specified parties, governed by the Privacy Act 2020.

find out more

Legal Photo Release Form

A New Zealand-compliant legal document that grants permission for the use of photographs, protecting both photographer and subject rights under NZ law.

find out more

Psychologist Release Of Information Form

A New Zealand-compliant authorization form for the release of psychological information, designed to protect client privacy rights while facilitating necessary information sharing.

find out more

Release Of Information Form Mental Health

A New Zealand-compliant form authorizing the release of mental health records, ensuring proper consent and privacy protection under local legislation.

find out more

Travel Release Form For Minor

A New Zealand-compliant legal document authorizing a minor's travel, either domestic or international, with specified conditions and emergency provisions.

find out more

Authorization To Release Personal Information

A New Zealand-compliant authorization form allowing individuals to permit the release of their personal information to specified parties under the Privacy Act 2020.

find out more

Participant Release Form

A New Zealand-compliant legal document obtaining participant consent, media rights, and liability release for various activities and events.

find out more

Video Release Consent Form

A New Zealand-compliant consent form for obtaining permission to record and use video footage of individuals, aligned with local privacy and media laws.

find out more

Customer Release Form

A New Zealand-compliant legal document that establishes liability waivers and release terms between businesses and their customers.

find out more

Termination Of Account Letter

A formal New Zealand-compliant letter document used to officially terminate an account relationship between a service provider and account holder.

find out more

Photography Consent Form

A New Zealand-compliant legal document establishing consent for photography capture, usage, and publication rights, governed by NZ law.

find out more

Consent To Share Medical Information Form

A New Zealand-compliant consent form for authorizing the sharing of patient medical information between healthcare providers and specified parties.

find out more

Consent Form To Share Information

A New Zealand-compliant consent form for organizations to legally obtain permission to collect, use, and share personal information under NZ privacy laws.

find out more

Authorization To Disclose Health Information Form

A New Zealand-compliant form authorizing the disclosure of patient health information under NZ privacy laws.

find out more

Disclosure Of Health Information Form

A New Zealand-compliant form for authorizing the disclosure of patient health information under the Privacy Act 2020 and Health Information Privacy Code.

find out more

Authorization Letter To Release Information

A New Zealand-compliant legal document authorizing the release of specific information from one party to another, subject to Privacy Act 2020 requirements.

find out more

Standard Medical Consent Form

A New Zealand-compliant medical consent form for documenting informed patient consent to medical procedures and treatments.

find out more

Records Release Form

A New Zealand-compliant legal document authorizing the release and transfer of specific records between parties, subject to privacy laws and data protection requirements.

find out more

Motor Vehicle Accident Release Form

A New Zealand-specific legal document that formalizes settlement agreements between parties involved in a motor vehicle accident, operating within the ACC framework.

find out more

Minor Consent To Treat Form

A New Zealand-compliant legal form authorizing healthcare providers to deliver medical treatment to minors with parent/guardian consent.

find out more

Injury Release Form

A New Zealand-compliant waiver document for acknowledging risks and releasing liability claims, designed to work within NZ's ACC scheme framework.

find out more

Employee Key Release Form

A New Zealand-compliant form documenting the issuance of keys/access devices to employees, outlining responsibilities and security protocols.

find out more

Authorization Release Form For Medical Records

A New Zealand-compliant legal form authorizing the release and transfer of patient medical records between specified parties under NZ privacy laws.

find out more

Temporary Guardian Medical Release Form

A New Zealand-compliant legal form that delegates temporary medical decision-making authority for minors to a designated guardian.

find out more

Simple Medical Consent Form

A New Zealand-compliant medical consent form for documenting patient approval for healthcare procedures and treatments.

find out more

Release Letter Form

A New Zealand-compliant legal document that formally releases one party from claims or obligations by another party.

find out more

Protected Health Information Form

A New Zealand-compliant form for managing protected health information collection, use, and disclosure in healthcare settings under NZ privacy laws.

find out more

Permission To Use Photo Agreement

A New Zealand-compliant agreement governing the authorized use of photographs, establishing terms between the copyright holder and the user.

find out more
See more related templates

ұԾ’s Security Promise

Genie is the safest place to draft. Here’s how we prioritise your privacy and security.

Your documents are private:

We do not train on your data; ұԾ’s AI improves independently

All data stored on Genie is private to your organisation

Your documents are protected:

Your documents are protected by ultra-secure 256-bit encryption

We are ISO27001 certified, so your data is secure

Organizational security:

You retain IP ownership of your documents and their information

You have full control over your data and who gets to see it