Get the free IMPLANT REFERRAL FORM - Ithaca Oral Surgery and Implant Center

IMPLANT REFERRAL FORM Ithaca Oral Surgery and Implant Center 1301 Trumansburg Road, Suite #G Ithaca, NY 14850 (607) 2730327 Phone (607) 2730328 Fax Ithacaoralsurgery×gmail.com For restorative dentists:

How to fill out implant referral form

How to fill out implant referral form:

1. Begin by carefully reading the instructions provided on the implant referral form. It is crucial to understand the information required and any specific guidelines mentioned.
2. Start by providing your personal information accurately, including your full name, contact details, and any relevant identification numbers (such as a patient or insurance number) that may be required.
3. Next, ensure you accurately provide the details of the patient who needs the implant. This includes their full name, contact information, date of birth, and any relevant medical history or conditions that could impact the implant procedure.
4. Specify the reason for the implant referral. You may need to provide details regarding the specific tooth or area in need of an implant, any previous dental treatments undertaken, and the reasons why implant treatment is necessary.
5. If applicable, provide any necessary information about the referring dentist or dental clinic. This may include their name, contact information, and any special instructions or preferences they may have for the implant procedure.
6. Complete any additional sections or questions on the form, such as insurance details, preferred implant materials, or any specific concerns or requirements you may have.

Who needs implant referral form:

1. Patients who require dental implants may need an implant referral form. This form helps ensure that there is clear communication between the referring dentist and the dentist or specialist who will be performing the implant procedure.
2. Dental specialists or implant surgeons who are being referred a patient for an implant procedure will also require the implant referral form. This helps them understand the patient's background, medical history, and specific requirements, allowing them to provide appropriate treatment.
3. Dental insurance companies or third-party payers may also request an implant referral form to validate the need for the procedure and provide coverage or preauthorization.

In summary, filling out an implant referral form requires accurate personal and patient information, specific details about the implant procedure, and any additional instructions or preferences. Both patients and dental specialists involved in the implant process may need the implant referral form for communication and documentation purposes.

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