Creating questionnaire forms

If none of the default forms listed in the Questionnaire Setup dialog box meets your need information.

To create a questionnaire forms, you can create new or edit the default forms. You can also set an expiration period for responses so that periodically your patients must reconfirm their i

1.   In the Questionnaire Setup dialog box, click New Form.

The New Questionnaire Form Options dialog box appears.

2.   Select one of the following:

·        Copy Selected Form to create a new form based on a selected one.

·        Start with Blank Form to create a new form from a blank template.  

3.   Click OK.

The Questionnaire Form Setup dialog box appears.


4.   In the Form Category list, select the form category that you want to use.

Note: The listed categories were set up previously.

5.   In the Form Name field, type the name that you want to use to identify this questionnaire form.

6.   In the Respondents list, select the group, such as patient or provider/staff, that will respond to this questionnaire.

Note: Some forms contain information that is patient-specific or provider/staff-specific. If you select a respondent group that is different from the group that the questions are tailored to, an error message appears.

7.   To include your practice contact information on the form, select Include Practice Information.

Note: Practice information is always included when you select Provider/Staff from the Respondents list.

8.   To set an expiration period for responses, select Responses to form expire every and then select the number of months that you want to elapse before your patients must reconfirm their responses.

9.   To require a signature, select one or more of the following:

·        Patient

·        Provider

·        Witness

Note: In the Form Questions pane, questions are listed under Question, and response types are listed on the same line under Response Type. Under Req, you can select the questions that you want to require an answer to. Dentrix will not allow the questionnaire to be submitted until all of the required questions are answered.

10. Edit the questions listed in the Form Questions pane.

Note: The questions appear on the questionnaire form in the same order and are set up as shown in the Form Questions pane.

11. Click View/Print Form to preview and print the form and then click Close.