5+ Dentist Prescription Pad Templates for MS Word [Download Free]

What is a dental prescription pad?

A dental prescription pad is one of the regularly used documents by a dentist. It is defined as a formal communication from a dental physician to a pharmacist, authorizing them to give a specific drug to a specific patient to whom medicine has been prescribed.

Who are dentists?

Dentists are trained professionals who care about the health of our teeth and mouth. Dentists usually have several responsibilities, the most important being good oral hygiene which prevents several complications in the mouth and overall body. Some of the core responsibilities of dentists include:




  • Making people aware of dental hygiene
  • Treating and filling cavities
  • Removing tooth decay
  • Removing damaged teeth or treating them
  • Keeping a check on the healthy growth of teeth and jawbones
  • Reviewing diagnosis and X-rays
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Download Ready-made Prescription Pad Templates

On this page, you can download prescription formats for a Dentist or anyone related to this medical domain, pre-designed in Microsoft Word. Each of these templates is designed for a US Letter size paper, but you can amend it a little to be used for an A4 or any other Paper size.

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Format of the prescription pad

For the dental prescription to be accepted as a legal medical prescription, it must be filled by a qualified and authorized dentist. Prescriptions can be either in the form of digital receipts sent directly to pharmacists, written on smaller paper forms, or preprinted prescription forms assembled in the form of dental prescription pads. In a few cases, the prescription can be transferred to the pharmacists orally by physicians. However, in each case, the content of the prescription remains the same name and address of the physician, his/her contact number, qualification, and dental registration number.

Basic legal requirements for filing a prescription pad

  • Prescriptions must be written with ink.
  • The prescriptions written on the prescription pad must be duly signed by the dentist.
  • It must include the name, address, and qualification of the prescriber.
  • Writing should be legible.
  • It must specify the full name and address of the patient. However, if the patient is below the age of five it must specify his/her age and date of birth.

Good practice points for filling out a prescription pad

  • A dentist’s prescription is an important document that relies on the treatment of the patient. If something goes wrong with the filling of a prescription pad, a serious health emergency can arise. Therefore, good practice points must be kept in mind while filling the pad which are described below:
  • Do not use abbreviations as because of this the patient might not be able to get the prescribed medicine.
  • Clearly state the name of the drug, its dosage, route of administration, and duration of treatment.
  • Always draw a diagonal line across the blank part of the prescription in the end so that fraudulent additions and alterations are not made.
  • If any alterations are made after writing of prescription, they must be properly defined, cleared of ambiguities, and must be affirmed by the dentist’s signatures.
  • Always check the allergy status of the patient before prescribing the medicine.
  • Check the status of all the medicines and non-prescribed items that the patient is currently taking so that these may not interfere with the new medicines prescribed.
  • Avoid the usage of unnecessary decimal points.
  • Take special caution in prescribing medicine to the high-risk group such as pregnant or breastfeeding women, children, and elderly people.
  • Advise patients on the possible side effects of the prescribed medicines and encourage them to report as soon as they experience any side effects.







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