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JEFFREY P. MILLER, D.D.S. PRACTICE LIMITED TO PERIODONTICS 340 DOGWOOD AVENUE, SUITE 101 FRANKLIN SQUARE, NEW YORK 11010 (516) 565-2018 Periodontal Enhancement Prescription Patient's Name:- Referred

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What is enhancement prescription perio form?

Enhancement prescription perio form is a document used to request an enhancement prescription for periodontal treatment.

Who is required to file enhancement prescription perio form?

This form is required to be filed by periodontists or dental professionals who are authorized to prescribe enhancement treatments for periodontal conditions.

How to fill out enhancement prescription perio form?

To fill out the enhancement prescription perio form, you need to provide the patient's personal information, medical history, details of the periodontal condition, prescribed treatments, and any additional relevant information requested in the form.

What is the purpose of enhancement prescription perio form?

The purpose of the enhancement prescription perio form is to document the need for enhancement treatments in cases of periodontal conditions and provide authorization for the prescribed treatments.

What information must be reported on enhancement prescription perio form?

The enhancement prescription perio form typically requires the reporting of patient's personal information, medical history, details of the periodontal condition, prescribed treatments, and any other relevant information that may be necessary for the authorization of enhancement treatments.

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