BlissDental Your Kendall General Dentist

(305) 274-6500

  • Dental Services
    • General
      • Cleanings
      • Dental Checkup
      • Emergency Dentist
      • Laser Dentistry
      • Pediatric Dental
      • Sedation Dentist
      • Full Mouth Reconstruction
      • Tooth Extraction
    • Restorative
      • All-on-4 Dental Implants
      • Dental Crowns and Bridges
      • Dental Implants
      • Dental Restorations
      • Full & Partial Dentures
      • Tooth Fillings
    • Cosmetic
      • Dental Veneers
      • Invisalign® Dentist
      • Smile Makeover
      • Zoom Teeth Whitening
    • Other
      • Botox
      • Juvéderm
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(305) 274-6500
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Patient registration form

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Patient Health History

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A.I.D.S/HIV Positive
Alcoholism
Allergies
Anemia
Arthritis
Asthma
Blood Disease
Bone Disease
Cancer
Chemical Dependency
Chest Pain
Circulatory Problems
Convulsions/Seizures
Diabetes
Excessive Bleeding
Epilepsy
Glaucoma
Hay fever
Header injuries
Hearing Impaired
Heart Disease
Heart Valve, Murmur
Hepatitis/Liver Disease
Hepatitis Carrier
High Blood Pressure
Hip or Joint replacement
HPV
Jaundice
Kidney Disease
Kidney Dialysis
Latex Sensitivity
Lupus
Low Blood Pressure
Malignancies
Mitral Valve Prolapse
Neck & Back Problems
Nervous Problems/Disorders
Pacemaker
Prosthetic Joints
Psychiatric Care
Radiation Treatment
Respiratory Problems/Disorders
Rheumatic Fever
Rheumatism
Scarlet Fever
Seizures/Fainting spells
Sinus Problems
Stomach Ulcers
Stroke
Thyroid Disease
Tuberculosis
Tumors or growths
Ulcers
Venereal Disease

 

Medical Questions

Do you have any disease/problem you think we should know about?
Are you allergic to any medications?
Are you in good health?
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Have you ever been hospitalized?
Have you had a transplant operation that has depreseed your immune system?
Do you smoke or chew tobacco?
Have you had Heart Surgery?
Are you now under the care of an MD?
Are you taking or have you ever taken bisphosphonates? (Fosamax or Actonel for osteoporosis, chemotherapy, etc)
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BlissDental Your Kendall General Dentist

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5 stars from 275 reviews

Contact Info

  • 8501 SW 124th Ave Ste 104
    Kendall, FL 33183
  • Phone: (305) 274-6500
Pay Here

Hours of Operation

Monday: 9:00AM to 5:00PM
Tuesday: 9:00AM to 7:00PM
Wednesday: 9:00AM to 5:00PM
Thursday: 9:00AM to 5:00PM
Friday: 9:00AM to 5:00PM
Saturday: 8:00AM to 2:00PM *
Sunday: Closed

*first Saturday of the month