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DEPARTMENT OF MANAGED HEALTH CARE
OFFICE OF PLAN MONITORING
DIVISION OF PLAN SURVEYSTECHNICAL ASSISTANCE GUIDE
QUALITY MANAGEMENT
ROUTINE DENTAL SURVEY
OF
PLAN NAMED ATE OF SURVEY:PLAN COPY
Issuance
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How to fill out routine dental survey
How to fill out routine dental survey
01
Start by reading the instructions and guidelines provided with the dental survey.
02
Gather all the necessary information and documents that you may need while filling out the survey.
03
Begin by filling out your personal information such as your name, address, phone number, and date of birth.
04
Follow the instructions to provide details about your dental history, such as any previous dental treatments, surgeries, or oral health issues.
05
Answer the questions regarding your current oral hygiene routine, such as the frequency of brushing, flossing, and mouthwash usage.
06
Provide information about any current dental problems or concerns you may have, such as toothache, sensitivity, or gum issues.
07
If applicable, mention any dental insurance coverage you have and provide necessary details.
08
Double-check all the answers and ensure that you haven't missed any required fields or questions.
09
Finally, submit the completed dental survey as instructed, either in person or online.
10
Keep a copy of the filled survey for your records or future reference.
Who needs routine dental survey?
01
Routine dental surveys are typically required for anyone who wishes to receive regular dental care or treatment.
02
This includes individuals of all ages, from children to adults.
03
Whether you have a specific dental concern or just need regular check-ups and cleanings, a routine dental survey helps dentists understand your oral health history and provide appropriate care.
04
Routine dental surveys are especially important for people with chronic dental conditions, such as periodontal disease or those who have undergone dental surgeries.
05
Employers or educational institutions may also require routine dental surveys as part of their health assessment processes.
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What is routine dental survey?
Routine dental survey is a form that records the dental status of an individual and is often required by certain organizations or authorities for various reasons.
Who is required to file routine dental survey?
Individuals may be required to file a routine dental survey by their employer, school, or healthcare provider.
How to fill out routine dental survey?
Routine dental surveys can typically be filled out by providing information about oral health history, current dental conditions, and any treatment received.
What is the purpose of routine dental survey?
The purpose of routine dental survey is to assess and monitor the dental health of individuals, identify any potential issues, and track changes over time.
What information must be reported on routine dental survey?
Information that may need to be reported on a routine dental survey includes personal details, oral health history, current dental conditions, and any treatment received.
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