Dental Recall System Checklist: Patient Reminders & Scheduling
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This Template was installed 2 times.
Patient Data Verification
Confirm accuracy of patient contact information (phone, email, address).
Patient First Name
Patient Last Name
Patient Date of Birth (Year)
Patient Date of Birth (Month)
Patient Date of Birth (Day)
Preferred Contact Method
Patient Phone Number
Patient Email Address
Recall Trigger Identification
Determine appropriate recall interval based on patient's treatment plan and risk factors.
Patient Risk Level
Recommended Recall Interval (Months)
Last Procedure Type
Date of Last Recall Appointment
Notes on Recall Trigger Justification
Reminder Method Selection
Choose optimal reminder method(s) – postcards, emails, text messages, phone calls.
Primary Reminder Method
Additional Reminder Methods (Optional)
Preferred Communication Time (If Applicable)
Maximum Retries (Text/SMS)
Default Language for Reminders
Reminder Scheduling & Timing
Set reminder dates and times considering office hours and patient preferences.
Initial Recall Date
Recall Interval (Months)
Preferred Reminder Time (Morning/Afternoon)
Reminder Frequency
Next Reminder Date (Auto-Generated)
Reminder Communication Content
Review and update reminder message content to ensure clarity and compliance.
Reminder Type
Email Subject Line
Text Message Body
Postcard Message
Phone Call Script
Personalized Greeting?
Include Treatment Details?
Include Appointment Link?
Response Tracking & Documentation
Record patient responses to reminders (confirmed, rescheduled, declined).
Reminder Method Received
Patient Response
Response Date
Response Time
Notes/Comments Regarding Response
Number of Attempts to Contact (if applicable)
Contact Method Used by Staff
Rescheduling Protocol
Follow established procedures for rescheduling declined or unanswered reminders.
Days to Reschedule (Default)
Reschedule Method
Proposed New Appointment Date
Proposed New Appointment Time
Reason for Reschedule (Patient Input)
Notes/Comments Regarding Reschedule
Reschedule Confirmation Status
System Audit & Review
Regularly audit the recall system's effectiveness and make necessary adjustments.
Percentage of Patients Recalled
Average Days Between Recall & Appointment
Reminder Methods Utilized (Select All)
Last System Audit Date
Summary of Audit Findings & Recommendations
Overall System Effectiveness (High, Medium, Low)
Next Scheduled Audit Date
Software/Platform Functionality
Verify recall system software/platform is functioning correctly (sending reminders, tracking responses).
Number of Reminders Sent Today
Number of Reminders Bounced/Failed
Default Reminder Method (e.g., Email, SMS)
Last System Data Backup Date
Time of Last Data Sync
Software Version
Legal & Compliance Review
Ensure recall practices comply with relevant privacy laws (HIPAA) and regulations.
Last HIPAA Training Completion Date
State-Specific Recall Laws Compliance?
Summary of Recent Legal/Compliance Updates Applied
Consent Forms Updated (HIPAA, Financial)
Copy of Current Consent Forms
Number of Patient Complaints Related to Privacy/Consent (last year)
Date of Last Privacy Policy Review
Dental Management Solution Screen Recording
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