Dental Office Observation Form

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Dental Hygiene Program
Dental Office Observation Form
Applicant: ___________________________________________________________
Please Print
Date of Observation: __________________________________________________
Dentist’s Name:
This is to verify that the above-named applicant spent 4-6 hours observing in this dental office.
Signature of Dentist: ___________________________________ Date: ________________
Signature of Applicant: __________________________________ Date: ________________
During your office visit, you may want to ask the following questions:
Responsibilities of the Dental Hygienist
What are the specific job duties related to dental hygiene practice?
What are other job duties related to dental office management and teamwork?
Patient Scheduling
How many patients are seen in a day by the dental hygienist?
How much time is allowed to see a patient?
How often are patients seen for recall appointments?
Work Environment
What is the length of work week (days of operation)?
What is the length of work day (daily hours)?
What type of uniforms are required in the office?
Who are the other members of the office staff and what are their general responsibilities?
Are staff meetings regularly scheduled and when?
Dental Hygiene as a Profession
What are the advantages of this profession?
What are the disadvantages of this profession?
5/2013 vh


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Parent category: Medical