Get the free DENTAL CT SCAN REFERRAL FORM - bronxadvancedcom

DENTAL CT SCAN REFERRAL FORM ADVANCED DENTAL Note to Patient: Please bring this referral form with you. Payment is due when services are rendered. Phone: (718) 2928988 Advanced Dental is not responsible

How to fill out dental ct scan referral

How to fill out a dental CT scan referral:

1. Begin by determining the reason for needing a dental CT scan referral. Common reasons include evaluating the position of impacted teeth, diagnosing temporomandibular joint disorders, assessing the size and location of dental infections, and planning for dental implant placement.
2. Obtain the necessary referral form from your dentist or oral surgeon's office. This form is typically provided to you by your dentist when they determine that a dental CT scan is necessary for your treatment.
3. Start by filling out your personal information on the referral form. This may include your full name, date of birth, contact information, and any relevant medical history.
4. Provide the name and contact information of the dentist or oral surgeon who will be receiving the referral. If you have already selected a specific provider, include their details. Otherwise, the dentist who gave you the referral may recommend a preferred specialist.
5. Indicate the reason for the referral by selecting the appropriate option on the form. This may involve checking a box or writing a brief description of your dental condition that necessitates the CT scan.
6. If you have any specific concerns or requests regarding the dental CT scan, make sure to communicate them clearly on the form. For example, if you are claustrophobic and would like to request an open CT scanner, include this information in the appropriate section.
7. Review the referral form carefully to ensure that all the information provided is accurate and complete. Any missing or incorrect information could delay the scheduling and processing of your appointment.
8. After filling out the referral form, return it to your dentist or oral surgeon's office. They will forward it to the imaging center or radiology department responsible for scheduling the CT scan.

Who needs a dental CT scan referral?

1. Patients who require extensive dental treatment, such as dental implant placement or complex extraction procedures, often need a dental CT scan referral. This allows the dentist or oral surgeon to carefully plan the treatment by visualizing the three-dimensional structure of the jawbone, teeth, and surrounding tissues.
2. Individuals with suspected or known dental infections that have spread beyond the tooth may require a dental CT scan referral. The scan helps determine the extent of the infection, assisting in accurate diagnosis and treatment planning.
3. Patients experiencing symptoms of temporomandibular joint disorders, such as chronic jaw pain, difficulty biting or chewing, or joint clicking, may be recommended to undergo a dental CT scan. This imaging technique provides detailed information about the joints' alignment and condition, aiding in an accurate diagnosis and guiding the appropriate treatment.
4. Individuals with impacted teeth, commonly wisdom teeth, may need a dental CT scan referral to evaluate the position, size, and angulation of the impacted teeth. This information helps the dentist or oral surgeon plan for a safe and effective extraction procedure.

Remember, it is important to consult with your dentist or oral surgeon to determine whether a dental CT scan referral is necessary for your specific dental condition. They will be able to guide you through the referral process and address any concerns you may have.

For pdfFiller’s FAQs

What is dental ct scan referral?

Dental CT scan referral is a request form used to refer a patient to get a dental CT scan.

Who is required to file dental ct scan referral?

Dentists and other healthcare professionals who determine that a patient needs a dental CT scan are required to file the referral.

How to fill out dental ct scan referral?

To fill out a dental CT scan referral, the healthcare professional must provide the patient's information, reason for referral, and any relevant medical history.

What is the purpose of dental ct scan referral?

The purpose of a dental CT scan referral is to diagnose and evaluate dental conditions that may not be visible through traditional imaging techniques.

What information must be reported on dental ct scan referral?

The dental CT scan referral must include the patient's name, date of birth, reason for referral, referring healthcare professional's information, and any relevant medical history.

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