Multi-Language Health History Forms

The Multi-Language Health History Project began as an initiative of the University of the Pacific Dental School (UOP) to address the needs of patients and dentists that do not speak the same language. This diversity in ethnicity, culture and language enriches our lives, but it also adds a challenge to communicating important health information that is needed for the safe provision of dental care.

The University of the Pacific Dental School has translated a thorough health history form into 21 different languages. The health history was translated, keeping the same question numbering sequence. Thereby, a dentist who speaks English and is caring for a patient who doesn’t, can ask the patient to complete the health history in his or her own language. The dentist then compares the English health history to the patient’s translated health history, scanning the translated version for “yes” responses. When a “yes” is found, the dentist is able to look at the question number and match it to the question number on the English version.

Go to and click on “Dental Professional” for the health history forms.