Get the free Orthodontic referral form - Orthodontist Cape Town

15 Kildare Road, New lands, Cape Town, 7700 Tells: (021) 674 6560 Fax: (021) 683 2880 email: info strydomorthodontics.co.ZA website: www.strydomorthodontics.co.zaOrthodontic referral form Date of

How to fill out orthodontic referral form

How to fill out orthodontic referral form

1. Start by gathering all necessary information about the patient, including their full name, date of birth, contact information, and relevant medical history.
2. Ensure that you have the required documentation, such as panoramic and cephalometric X-rays, dental models, photographs, and any additional diagnostic records.
3. Fill out the patient's personal information accurately in the designated fields on the referral form.
4. Provide a detailed description of the patient's chief complaint or reason for seeking orthodontic treatment.
5. Enumerate any specific concerns or relevant findings from the orthodontic examination, outlining any orthodontic anomalies or dental abnormalities.
6. Include any pertinent medical history, such as previous surgeries, allergies, or systemic conditions that may impact orthodontic treatment.
7. Indicate the recommended orthodontic treatment plan, outlining the specific procedures, appliances, or interventions that are deemed appropriate for the patient.
8. Attach or include copies of the necessary diagnostic records, such as X-rays, models, or photographs.
9. Provide your contact information and signature to facilitate communication and ensure the authenticity of the referral form.
10. Double-check all information for accuracy and completeness before submitting the orthodontic referral form.

Who needs orthodontic referral form?

1. Orthodontic referral forms are typically required for individuals who wish to undergo orthodontic treatment.
2. This includes patients who may have crooked teeth, misaligned jaws, or other dental irregularities that can be corrected with orthodontic interventions.
3. Orthodontists may require a referral form to gather relevant information about the patient's dental history, medical conditions, and any previous orthodontic treatment that has been done.
4. Referral forms help orthodontists assess the patient's orthodontic needs and develop an appropriate treatment plan tailored to their unique circumstances.

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What is orthodontic referral form?

An orthodontic referral form is a document used by dental professionals to refer a patient to an orthodontist for specialized treatment.

Who is required to file orthodontic referral form?

Typically, general dentists or dental practitioners are required to file the orthodontic referral form when they identify the need for orthodontic evaluation or treatment for a patient.

How to fill out orthodontic referral form?

To fill out the orthodontic referral form, the referring dentist needs to provide patient information, clinical findings, reason for referral, and any relevant medical history.

What is the purpose of orthodontic referral form?

The purpose of the orthodontic referral form is to communicate essential patient information and treatment needs from the referring dentist to the orthodontist.

What information must be reported on orthodontic referral form?

The information reported on the orthodontic referral form typically includes patient demographics, specific dental issues, rationale for the referral, and any pertinent medical history.