Your Medical History: Helping Us Care for You Safely

Before attending for an appointment here at Crossbank Dental Care, please take a moment to complete or update your medical history form.

You will be sent a link to your medical history form prior to your appointment. Completing your medical history form helps us ensure your care is safe, informed, and aligned with your current health and medications. Even small changes in your medical status or prescriptions can make a difference to how we approach your treatment.

Accessing the medical history form

If you are using your smart phone please click the link within the email, or alternatively, if you are unable to click the link, please copy and paste the link into your web browser.

You will be directed to a secure website with our logo at the top. Once there, please follow these steps:

1. Click "log in".

2. Fill in your first name, second name, date of birth and mobile phone number. (Note: This process only works if we have your mobile number on file.)

3. Click "continue".

4. Once your record is found, confirm your personal details and click "Send me an SMS code".

5. Enter the 6-digit code that has been sent to your phone, then click "Continue."

6. You’ll be prompted to create a password. Your password must be:

   
   

   • 8–50 characters long

   • Include one uppercase, one lowercase, one number, and one special character

   • No spaces or emojis allowed

   
   

7. Check your email (the one registered with us) for a verification link. Click the link to verify your email.

8. Return to the screen, click the "X" in the top right corner, then enter your date of birth and click "Continue."

Filling out the medical history form

• Your first question will appear.

• Carefully read and answer each question — all questions are mandatory.

• If you answer "yes" to any question, additional fields will appear for more information.

• Once complete, confirm the accuracy of your answers, then click "Sign."

  
  

Updating previous pnformation

If you have filled out the form before and log in using the steps above, your previous answers will be saved. You can review and update as needed. Any new or edited answers will need to be completed from scratch.

Having trouble?

If you encounter issues logging in, go back to the first page and click "Fill in a new form." Note: This method will not retrieve your previously saved answers.

Thank you for helping us give you the highest standard of care.