Get the free DeNTAl IMAGING RefeRRAl fORM - bmaidstoneperiobbcobbukb - maidstoneperio co

Dental Imaging Referral Form 10 Pankhurst Close Grove Green Maidstone Kent ME14 5BT Tel: 01622 739962 Fax: 01622 737567 info maidstoneperio.co.UK www.maidstoneperio.co.uk 1. Referred by: Practice

How to fill out dental imaging referral form

How to fill out a dental imaging referral form:

1. Start by providing your personal information, such as your full name, contact number, and mailing address. This information helps the dental imaging facility to communicate with you and send any necessary reports or results.
2. Fill in the details of your dentist or primary healthcare provider who is referring you for the dental imaging. Include their name, clinic name, contact information, and any specific instructions they have given for the referral.
3. Specify the type of dental imaging you require. This may include options such as X-rays, panoramic imaging, cone beam computed tomography (CBCT), or any other specialized imaging required for your dental condition.
4. Indicate the reason for the referral. This is where you can describe your dental issue or symptoms that require further investigation through imaging. Be as specific as possible to help the imaging facility understand the purpose of the referral.
5. If you have any relevant medical history or previous dental imaging results that may aid in the diagnosis, mention them in the designated section. This provides the imaging facility with a comprehensive understanding of your overall oral health and assists in interpreting the results accurately.
6. Check if there are any specific insurance or billing requirements. Some imaging facilities may require this information in advance to streamline the payment process, while others may handle insurance claims directly.

Who needs a dental imaging referral form:

1. Patients who require specialized dental imaging procedures: Dental imaging referral forms are often needed for patients who need advanced or specific types of dental imaging beyond routine dental X-rays. These may include individuals with complex dental conditions, suspected oral pathology, implant planning, orthodontic evaluation, or pre-surgical assessments.
2. Patients referred by dentists or primary healthcare providers: The referral form is typically used by dentists or primary healthcare providers to refer their patients to a dental imaging facility. It ensures seamless communication between the referring dentist and the imaging facility, facilitating coordinated patient care.
3. Individuals seeking a second opinion: Patients who wish to seek a second opinion from another dental professional may need a referral form to share their previous imaging and relevant information with the new practitioner. This enables the new provider to have access to the necessary imaging and make an informed diagnosis or treatment plan.

Overall, dental imaging referral forms are necessary for patients who require specialized dental imaging and for effective communication between dental professionals involved in the patient's care.

For pdfFiller’s FAQs

What is dental imaging referral form?

The dental imaging referral form is a document used to refer a patient to a specialist for dental imaging procedures.

Who is required to file dental imaging referral form?

Dentists and dental professionals who need to refer a patient for dental imaging procedures are required to file the dental imaging referral form.

How to fill out dental imaging referral form?

To fill out the dental imaging referral form, the referring dentist or dental professional must provide the patient's information, reason for referral, and any relevant medical history.

What is the purpose of dental imaging referral form?

The purpose of the dental imaging referral form is to ensure that patients receive the necessary dental imaging procedures from a specialist.

What information must be reported on dental imaging referral form?

The dental imaging referral form must include the patient's name, date of birth, reason for referral, referring dentist's information, and any relevant medical history.

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