Abstract
A medical interview sheet has an important role in obtaining information about a patient in every situation for medical treatments. The sheet is usually written in Japanese. Some people have difficulties in filling the form due to both the complicated style of Japanese sentences and their language ability. In this report we study the structure of the interview sheet that is supposed to be used at a dental clinic situation. We also investigate the use of a signed language explanation as a supplemental information channel for deaf people who use a signed language in everyday life. Furthermore, results for preliminary evaluation testing of the interview sheet are shown.