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Home › Dental (ADEX) › ADEX Dental Exam Forms – Choose Year › 2020 Dental Exam Forms

2020 Dental Exam Forms


2020 Dental Exam Forms  – For exams taken in the 2020 calendar year

Restorative Criteria (ADEX)

  • Anterior Composite Preparation
  • Anterior Composite Restoration
  • Posterior Amalgam Preparation
  • Posterior Amalgam Restoration
  • Posterior Composite Preparation
  • Posterior Composite Restoration

Restorative Administrative Forms

  • Anterior Progress Form
  • Posterior Progress Form
  • Chairside Assistant – (Print on Yellow Paper)
  • Interpreter Disclosure Statement/ID Forms – (Print on Green Paper)
  • Medical History
  • Modification Request Form
  • Patient Consent Disclosure and Assumption of Responsibility
  • Qualified Patient/Tooth/Lesion Treatment Form (For CIF Exams only)

Periodontal Criteria (ADEX)

  • Periodontal Clinical Examination

Periodontal Administrative Forms

  • Periodontal Progress Form
  • ADEX Periodontal Clinical Exam Declaration Form
  • Chairside Assistant – (Print on Yellow Paper)
  • Interpreter Disclosure Statement/ID Forms – (Print on Green Paper)
  • Medical History
  • Patient Consent Disclosure and Assumption of Responsibility
  • Treatment Selection Worksheet

Endodontic Criteria (ADEX)

  • Anterior Endodontic Procedure
  • Posterior Endodontic Procedure

Prosthodontics Criteria (ADEX)

  • Cast Metal Crown Preparation
  • Ceramic Crown Preparation
  • Porcelain Fused to Metal Crown Preparation

Endodontic and Prosthodontic Administrative Form

  • Prosthodontics & Endodontics Clinical Examinations Progress Form
  • Exam Registration
  • FAQs
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