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Cone Beam CT Referral Form
PatientdetailsName:DOB: DD / MM / YYYYMale Female Address:
Postcode:
Home Tel:Work Tel:Mobile Tel:Region requiring imaging:Image size
5 × 5.5cm8 x 5.5cm8 x 8cmSide of mouth
LEFTRIGHTJustification
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How to fill out cone beam ct referral

How to fill out cone beam ct referral
01
Gather the patient's information including their name, date of birth, and contact details.
02
Obtain the necessary medical history, including any pre-existing conditions, current medications, and allergies.
03
Determine the reason for the cone beam CT referral, whether it is for a specific dental issue or for general evaluation.
04
Select the appropriate cone beam CT machine based on the specific requirements of the referral.
05
Prepare the patient for the cone beam CT scan by providing any necessary instructions such as fasting or removing any metal objects.
06
Schedule an appointment for the patient to undergo the cone beam CT scan.
07
Ensure that the referral form is properly filled out, including all relevant information such as the patient's demographics, medical history, and reason for the referral.
08
Submit the completed cone beam CT referral form to the appropriate healthcare provider or imaging center.
09
Follow up with the patient to confirm their cone beam CT scan appointment and provide any further instructions as needed.
10
Keep a copy of the cone beam CT referral form for your records.
Who needs cone beam ct referral?
01
Dentists may need to make cone beam CT referrals for their patients who require further examination or evaluation of dental conditions.
02
Maxillofacial surgeons may also need cone beam CT referrals for patients who need detailed imaging for pre-surgical planning or to assess the extent of facial trauma.
03
Orthodontists may require cone beam CT referrals to assess the position and orientation of teeth and jaws in orthodontic treatment planning.
04
Endodontists may need cone beam CT referrals to evaluate complex root canal cases or to diagnose and treat conditions involving the tooth root and surrounding structures.
05
Periodontists may use cone beam CT referrals for assessing bone density and morphology in implant placement procedures or for evaluating periodontal diseases.
06
Other healthcare providers or specialists may also require cone beam CT referrals depending on their specific areas of practice and patient needs.
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What is cone beam ct referral?
Cone beam CT referral is a request from a healthcare provider to perform a cone beam computed tomography scan on a patient.
Who is required to file cone beam ct referral?
Any healthcare provider who deems it necessary to perform a cone beam CT scan on a patient is required to file a referral.
How to fill out cone beam ct referral?
To fill out a cone beam CT referral, the healthcare provider must provide the necessary patient information, reason for the scan, and any other relevant details.
What is the purpose of cone beam ct referral?
The purpose of a cone beam CT referral is to obtain detailed imaging of a specific area of the body for diagnostic or treatment purposes.
What information must be reported on cone beam ct referral?
The cone beam CT referral must include the patient's demographics, medical history, reason for the scan, referring provider information, and any pertinent clinical details.
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