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Dental Referral Form RoutinePriority: Today's Date:/ Urgent (recent trauma, pain, swelling) /Coverage:Patient Name: DOB:/ Care Oregon Plus Child/Maternal / Sex: Male Female Medicaid ID #: Care Oregon
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What is dental referral form?
The dental referral form is a document that allows a dentist to refer a patient to another dental specialist for further treatment.
Who is required to file dental referral form?
Any dentist who wishes to refer a patient to another dental specialist is required to file the dental referral form.
How to fill out dental referral form?
To fill out a dental referral form, the dentist must provide the patient's information, reason for the referral, and any relevant medical history.
What is the purpose of dental referral form?
The purpose of the dental referral form is to ensure that patients receive appropriate and specialized dental care from a specialist.
What information must be reported on dental referral form?
The dental referral form must include the patient's name, contact information, reason for referral, relevant medical history, and the referring dentist's information.
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