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42Specialist Referral Form
Referring Dentist:the dental practiceAddress42 Cambridge Road
Notting Hill Gate
London W11 3HN
Tel: 020 7229 5542
Fax: 020 7229 1200Telephone/Fax:
Email
Patient Name
Patient
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How to fill out referring dentist

How to fill out referring dentist
01
To fill out a referring dentist form, follow these steps:
02
Start by entering the patient's information, such as their name, date of birth, and contact details.
03
Provide the dental office's information, including the name, address, and contact information.
04
Specify the reason for the referral and the treatment required.
05
Include any relevant diagnostic information or tests that have already been performed.
06
Provide any additional notes or instructions for the referred dentist.
07
Finally, sign and date the form before submitting it to the referred dentist.
Who needs referring dentist?
01
A referring dentist is needed in situations when a patient requires specialized dental treatment that the current dentist is unable to provide.
02
Common scenarios where a patient may need a referring dentist include:
03
- Complex orthodontic cases requiring the expertise of an orthodontist.
04
- Oral surgery procedures, such as wisdom tooth extraction or dental implant placement.
05
- Endodontic treatments, like root canal therapy.
06
- Periodontal disease management and treatment.
07
In such cases, the referring dentist acts as a gateway to connect the patient with a specialist who can better address their dental needs.
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What is referring dentist?
Referring dentist is a dental provider who refers a patient to another dental provider for specialized treatment.
Who is required to file referring dentist?
The referring dentist or the dental office responsible for the referral is required to file referring dentist.
How to fill out referring dentist?
Referring dentist information should be filled out on the referral form provided by the dental office, including the name, address, and contact information of the referring dentist.
What is the purpose of referring dentist?
The purpose of referring dentist is to ensure proper communication and coordination of care between dental providers for the benefit of the patient.
What information must be reported on referring dentist?
The information reported on referring dentist should include the name, address, and contact information of the referring dentist, as well as any relevant medical history or treatment recommendations.
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