Free Templates

Dentist Note Templates for Work & School

Professional dentist note templates with all required elements for employers and schools. Free to download and customize for your dental practice.

10 min readDecember 2025PatientNotes Team
Dentist Note Template Guide

What is a Dentist Note?

A dentist note (also called a dental excuse letter or dental appointment verification) is a professional document provided by a dental office to verify a patient's appointment for employers, schools, or other institutions.

Unlike detailed medical records, dentist notes serve as simple verification that a patient attended a dental appointment. They typically don't include specific treatment details due to HIPAA privacy requirements, but they provide enough information for employers and schools to excuse an absence.

Work Excuses

Verify absence for employers and HR departments

School Excuses

Document absences for school administration

Insurance Claims

Support disability or leave claims

Dentist Note for Work

Work Excuse Template

[DENTAL PRACTICE NAME]

[Address] | [Phone] | [Email]
License #: [NUMBER]

DENTAL APPOINTMENT VERIFICATION

Date: _______________

To Whom It May Concern,

This letter confirms that                      (Patient Name) was seen at our dental office on                      (Date) from          to          (Time).

The patient received dental treatment during this appointment.

The patient may return to work on:                     

Additional notes (if applicable): ________________________

________________________________________________________

Dentist Signature

Date

Dr. [NAME], DDS/DMD
NPI: [NUMBER]

When Employers May Request a Dentist Note

  • Absences during high-demand periods or important meetings
  • Multiple dental appointments within a short period
  • Absences of 3 or more consecutive days
  • As per company policy for all medical/dental absences
  • For FMLA or disability documentation

Dentist Note for School

School Excuse Template

[DENTAL PRACTICE NAME]

[Address] | [Phone] | [Email]

SCHOOL ABSENCE EXCUSE

Date: _______________

To: School Administrator

School Name: ________________________________

Student Name:                             

Date of Birth:                     Grade:         

Appointment Details:

Date of Appointment: _______________

Time In: ___________ Time Out: ___________

Reason: [ ] Routine Checkup [ ] Dental Procedure [ ] Emergency

Student may return to school on:                     

Restrictions (if any): ________________________________

____________________________________________________

Authorized Signature

Date

Office Contact: [PHONE]
For verification, please call during business hours.

Important for School Notes

  • • Always include exact arrival and departure times
  • • Specify the date when the student can return to school
  • • Note any physical restrictions (no PE, limited activity)
  • • Include contact info for verification by school staff
  • • Some schools require specific forms—check with the school first

Required Elements for Dentist Notes

Essential Elements

  • 1

    Practice Information

    Letterhead with name, address, phone, and license number

  • 2

    Patient Information

    Full name and date of birth (for schools)

  • 3

    Appointment Date & Time

    Specific date and time range of visit

  • 4

    Return Date

    When patient can return to work/school

  • 5

    Signature

    Dentist's signature with credentials (DDS/DMD)

Optional Elements

  • +

    General Reason

    "Dental treatment" or "dental procedure" (no specifics)

  • +

    Activity Restrictions

    Any limitations on physical activity

  • +

    Follow-up Date

    Next scheduled appointment if applicable

  • +

    NPI Number

    For insurance verification purposes

  • +

    Practice Stamp/Seal

    Official stamp for added authenticity

Dentist Note Examples

Example 1: Routine Dental Checkup

SMILE DENTAL CLINIC

123 Main Street, Anytown, USA 12345 | (555) 123-4567

December 18, 2025

To Whom It May Concern,

This letter confirms that John Smith was seen at our dental office on December 18, 2025 from 9:00 AM to 10:30 AM for a routine dental examination and cleaning.

The patient may return to work/school immediately with no restrictions.

Please contact our office with any questions.

Dr. Sarah Johnson, DDS
License #12345

Example 2: Dental Procedure with Recovery Time

ADVANCED DENTAL CARE

456 Oak Avenue, Suite 200, Cityville, USA 54321 | (555) 987-6543

December 18, 2025

To Whom It May Concern,

This letter confirms that Maria Garcia was seen at our dental office on December 18, 2025 from 2:00 PM to 4:30 PM for a dental procedure.

Due to the nature of the treatment, the patient requires recovery time and may return to work on December 20, 2025.

Restrictions: No strenuous physical activity for 48 hours.

Please contact our office with any questions.

Dr. Michael Chen, DMD
License #67890 | NPI: 1234567890

Example 3: Emergency Dental Visit

EMERGENCY DENTAL CENTER

789 Urgent Care Blvd, Metro City, USA 98765 | (555) 911-TOOTH

December 18, 2025

To: Lincoln High School Administration

Re: Student Absence Excuse
Student: Emily Thompson
Grade: 10th | DOB: March 15, 2010

This letter confirms that the above-named student was seen at our dental office on December 18, 2025 from 10:45 AM to 1:30 PM for emergency dental treatment.

The student may return to school on December 19, 2025. No physical education activities for 24 hours.

For verification, please call (555) 911-TOOTH.

Dr. Robert Williams, DDS
License #11223

Best Practices for Dental Offices

Do This

  • • Use official letterhead with practice information
  • • Include specific dates and times
  • • Sign each note with proper credentials
  • • Keep copies of all notes provided
  • • Use consistent formatting across all notes
  • • Provide contact information for verification
  • • Specify return-to-work/school date clearly
  • • Use professional, clear language

Avoid This

  • • Including specific treatment details (HIPAA)
  • • Backdating or predating notes
  • • Providing notes for patients not seen
  • • Using vague or unclear language
  • • Omitting signature or credentials
  • • Leaving dates and times blank
  • • Providing notes without verification
  • • Using personal rather than practice letterhead

Legal Warning: Fraudulent Notes

Creating, altering, or using fraudulent dentist notes is illegal and can result in termination, academic consequences, and potential criminal charges. Dental offices should never provide notes for appointments that didn't occur, and individuals should never alter or forge dental documentation.

Digital Solutions for Dental Documentation

Modern dental practices are moving toward digital documentation solutions that streamline the process of creating, storing, and distributing dental notes. These tools can significantly reduce administrative burden while improving accuracy and compliance.

Template Libraries

Pre-built templates that auto-populate with patient and appointment data from your practice management system.

Digital Signatures

Secure electronic signatures that comply with legal requirements while speeding up the documentation process.

Direct Delivery

Send notes directly to employers or schools via secure email or patient portals with automatic audit trails.

Benefits of Digital Dental Documentation

  • Faster note generation (seconds vs. minutes)
  • Reduced errors from manual data entry
  • Automatic record keeping and audit trails
  • Professional, consistent formatting
  • Easy verification for recipients
  • HIPAA-compliant storage and transmission

Frequently Asked Questions

What should be included in a dentist note for work?

A dentist note for work should include: dental practice letterhead or logo, patient's full name, date and time of appointment, statement that patient was seen for dental treatment, duration of visit, return-to-work date if applicable, dentist's signature and credentials, and contact information for verification. Specific treatment details are typically not required due to privacy.

Can a dentist note be used as a sick note?

Yes, a dentist note can serve as a sick note for dental-related absences. Dental appointments and procedures are valid reasons for absence from work or school. For absences of 3 or more consecutive days, some employers may require more detailed documentation or a formal medical excuse from a healthcare provider.

How long is a dentist note valid?

A dentist note is typically valid for the specific date(s) mentioned in the document. For ongoing treatment, the note should specify the treatment period and expected duration. Most employers accept notes submitted within a reasonable timeframe (1-3 days) after returning to work.

Do dentist notes include treatment details?

Dentist notes generally do not include specific treatment details due to HIPAA privacy requirements. The note confirms the appointment occurred and may include general information like "dental procedure" or "dental treatment" without specifying the exact nature of the work. Detailed treatment information requires patient consent to share.

Can schools require a dentist note for absences?

Yes, schools can require a dentist note to excuse dental-related absences. The note should include the student's name, appointment date and time, duration of absence, when the student can return to school, and the dental office contact information. Some schools have specific forms they prefer dental offices to use.

Streamline Your Dental Documentation

PatientNotes AI helps dental practices generate professional notes and documentation automatically. Save time on paperwork and focus on patient care.

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