Templates · Prescription
Dental prescription template
A free prescription pad in English and Arabic, A5. Type on it and print it, or download the blank PDF.
Tap any line on the sheet to type on it. Nothing you type leaves your browser.
Free template from OnlyTeeth · onlyteeth.app
How to write a dental prescription
Every drug line needs the same six parts, in the same order, so the pharmacist and the patient can't misread it.
| Drug name | Generic name, or the brand if your faculty or country prefers it. Write it clearly; never abbreviate drug names. |
|---|---|
| Strength | With units: mg, g, mL. Never a trailing zero (5 mg, not 5.0 mg). |
| Form | Tablets, capsules, suspension, mouthwash, gel. |
| Dose and frequency | How much and how often, in words the patient understands: "1 tablet every 8 hours after meals". |
| Duration | For how many days, especially for antibiotics. |
| Quantity | The number of tablets or the pack size to dispense. |
Format example: Ibuprofen 400 mg tablets — 1 tablet every 8 hours after meals for 3 days — 1 pack. This shows the layout only. It is not a dose recommendation: choose drugs and doses from your faculty's protocol and the patient's history.
Checks before you sign
- Medical history and allergies. Penicillin allergy, anticoagulants, pregnancy, asthma with NSAIDs, kidney and liver disease, other medicines. Write the allergies on the sheet.
- Age and weight for children. Paediatric doses are by weight.
- Interactions with what the patient already takes.
- Legible, dated and signed, with your name and stamp. Students: your supervisor signs if your faculty requires it.
- Tell the patient what each medicine is for and when to stop, and write the next visit date on the sheet.
Make it in your own name, in English or Arabic
In OnlyTeeth, a prescription comes from the case you're treating: the patient's details are already filled in. It prints with your logo and signature, in English or Arabic, and you can send it as a PDF or on WhatsApp. Prescriptions are part of OnlyTeeth Premium; every new account gets 30 days of Premium free.
Questions
Can I use this template in my clinic?
Yes, it's free to use, print and share. Check that your country's rules don't require extra details on a prescription, such as a registration number.
How do I add my clinic's details before printing?
Tap the lines at the top of the sheet and type, then press "Print or save as PDF". Save it as a PDF once and you have your own pad to print from.
Why is it A5?
A5 (half an A4) is the usual prescription pad size. To print two on one A4 sheet, choose "2 pages per sheet" in the print dialog.
More templates: Dental lab order form · Dental CV