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Informatie | Verplicht | In Evolution | |||
|---|---|---|---|---|---|
First name | Ja | Eerste naam | |||
Last Name | Ja | Geslachtsnaam | |||
Date Of Birth | Ja | Birth date | Land line number | Nee | Hm PhGeboortedatum |
Sex | Ja | Geslacht | |||
Mobile number | Ja | MobileMobiel | |||
email Email address | Ja | ||||
When last visited the dentist | Nee | Appointment notes | |||
Where last seen | Nee | Appointment notes | |||
Information about your immediate dental needs | Nee | Appointment notesE-mail | |||
Medical considerations or additional information | Nee | Afspraakopmerkingen |
Receptionists can see the new patient booking
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