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GUMSHOED PRESCRIPTION FORM Bridge Dental Laboratory Ltd. Units 811, Sea Vixen Industrial Estate, Waverley Road, Christchurch, Dorset BH23 3RU Tel: 01202 486113 info bridgedentallab. Comment's Name:
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How to fill out gumshield prescription form

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How to fill out gumshield prescription form

01
Fill out your personal information, including your name, address, and contact details.
02
Provide information about your dentist or healthcare professional who will be prescribing the gumshield. Include their name, address, and contact details.
03
Specify the type of gumshield you need, such as a custom-made or boil-and-bite gumshield.
04
Indicate any specific requirements or measurements for your gumshield, if applicable.
05
Sign and date the form to confirm that all the information provided is accurate and complete.

Who needs gumshield prescription form?

01
Individuals who require a gumshield for dental protection during sports activities.
02
Athletes participating in contact sports, such as football, rugby, hockey, or martial arts, may need a gumshield.
03
People who have a history of teeth grinding or jaw clenching may also require a gumshield.
04
Those who have undergone dental procedures, such as orthodontic treatment or restorative work, may need a gumshield to protect their teeth.
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The gumshield prescription form is a document used to prescribe a customized mouthguard for a patient.
Dentists, orthodontists, or other dental professionals are required to file the gumshield prescription form.
To fill out the gumshield prescription form, the dental professional must provide the patient's information, the type of mouthguard prescribed, and any specific details or instructions.
The purpose of the gumshield prescription form is to document the prescription of a customized mouthguard for a patient to ensure proper fit and use.
Information such as patient's name, contact information, type of mouthguard prescribed, date of prescription, and any specific instructions must be reported on the gumshield prescription form.
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