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Tongue Tie (Ankyloglossia) Release Referral
Kirk D. Hamilton, MD, CCP (PC), CFP
Palliative Care and Family Medicine Obstetrics
510 South dale Rd E. Unit 101
London, Ontario N6E 0B2
Phone: 5194722920
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How to fill out tongue tie ankyloglossia release

How to fill out tongue tie ankyloglossia release
01
To fill out tongue tie ankyloglossia release, follow these steps:
02
Gather all necessary documents, including the patient's medical records and any consent forms required by the hospital or surgeon.
03
Complete the patient information section, providing the patient's full name, date of birth, and contact information.
04
Provide details about the procedure, such as the date and time it is scheduled, the type of anesthesia to be used, and any specific instructions or precautions for the patient.
05
Include information about the surgeon or medical professional who will be performing the procedure, including their name, credentials, and contact information.
06
Document any pre-operative instructions or preparations, such as fasting requirements or medication restrictions.
07
Fill out any additional sections or forms required by the hospital or healthcare facility, such as financial or insurance information.
08
Review the completed form for accuracy and completeness, ensuring all required fields are filled out and all necessary signatures are obtained.
09
Submit the form to the appropriate department or individual, following any specific submission instructions provided.
10
Keep a copy of the filled-out form for your records, and provide a copy to the patient if necessary.
11
Note: It is important to consult with a healthcare professional for specific instructions or guidance on how to fill out tongue tie ankyloglossia release, as the process may vary depending on the healthcare facility or surgeon.
Who needs tongue tie ankyloglossia release?
01
Tongue tie ankyloglossia release is generally recommended for individuals who experience difficulties related to tongue mobility or oral function due to a restricted or shortened frenulum (the small fold of tissue connecting the underside of the tongue to the floor of the mouth).
02
This procedure may be necessary for infants or children who have difficulty breastfeeding or may benefit from improved tongue movement for proper speech and oral development.
03
In some cases, tongue tie ankyloglossia release may also be recommended for older children or adults who continue to experience difficulties with speech, eating, or other oral functions due to tongue mobility issues.
04
A healthcare professional, such as a pediatrician, dentist, or speech therapist, can evaluate the need for tongue tie ankyloglossia release and provide guidance on whether the procedure is appropriate for an individual.
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What is tongue tie ankyloglossia release?
Tongue tie ankyloglossia release is a surgical procedure that involves cutting the frenulum, the thin band of tissue that connects the underside of the tongue to the floor of the mouth. This procedure is performed to improve the range of motion of the tongue for better feeding, speech, and oral hygiene.
Who is required to file tongue tie ankyloglossia release?
Typically, healthcare providers such as dentists or oral surgeons who perform the procedure on patients are required to file tongue tie ankyloglossia release. This filing often includes providing documentation to relevant health authorities.
How to fill out tongue tie ankyloglossia release?
To fill out a tongue tie ankyloglossia release, the healthcare provider should complete the necessary forms by providing patient information, details of the procedure performed, date of the release, and any post-operative care instructions required for the patient.
What is the purpose of tongue tie ankyloglossia release?
The purpose of tongue tie ankyloglossia release is to alleviate the functional limitations caused by a tight frenulum, which can impede breastfeeding, speech development, and proper oral hygiene. It aims to enhance the overall quality of life for the affected individual.
What information must be reported on tongue tie ankyloglossia release?
Information that must be reported includes the patient's identifying information, the findings from the examination, details of the procedure including date and any complications, as well as recommendations for follow-up care.
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