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415.897.4191 info marinbraces.com marinbraces.com 1730 Novato Blvd., Suite I Navajo, CA 94947DOCTOR INFORMATION REFERRING DOCTORS NAME: DOCTORS PHONE: OFFICE CELL PRACTICE NAME: OTHER DOCTORS EMAIL:

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How to fill out dentist-referral-marinbraces-1-25-18

01

Start by gathering all the necessary information, such as the patient's name, contact details, and dental insurance information.

02

Fill out the referral form with the patient's relevant medical history, including any existing dental conditions or treatments.

03

Provide detailed information about the reason for the referral, specifying the required orthodontic treatment or procedure.

04

Attach any supporting documents, such as dental X-rays or images, that are relevant to the referral.

05

Make sure to include the referring dentist's name, contact information, and any additional notes or comments.

06

Double-check all the information filled out on the form for accuracy and completeness.

07

Once everything is filled out correctly, submit the referral form to the designated orthodontic clinic or specialist.

08

Keep a copy of the filled out referral form for your records and for future reference if needed.

Who needs dentist-referral-marinbraces-1-25-18?

01

Anyone who requires orthodontic treatment or dental procedures that are beyond the scope of general dentistry may need to fill out the dentist-referral-marinbraces-1-25-18 form. This form is usually used by referring dentists to send patients to orthodontic specialists or clinics for further evaluation or treatment. Patients with complex orthodontic cases, such as those needing braces or jaw realignment, may be suitable for this referral.

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What is dentist-referral-marinbraces-1-25-18?

Dentist-referral-marinbraces-1-25-18 is a specific form used by dentists to refer patients to orthodontic specialists for braces and other orthodontic treatments.

Who is required to file dentist-referral-marinbraces-1-25-18?

Dentists who wish to refer patients to orthodontic specialists for brace treatments are required to file dentist-referral-marinbraces-1-25-18.

How to fill out dentist-referral-marinbraces-1-25-18?

To fill out dentist-referral-marinbraces-1-25-18, a dentist must provide patient details, nature of the referral, and any relevant medical history that is necessary for the orthodontic evaluation.

What is the purpose of dentist-referral-marinbraces-1-25-18?

The purpose of dentist-referral-marinbraces-1-25-18 is to facilitate communication between the referring dentist and the orthodontic specialist to ensure appropriate patient care.

What information must be reported on dentist-referral-marinbraces-1-25-18?

The form must report the patient's name, contact information, dental history, treatment needs, and any specific concerns the referring dentist has regarding the patient's orthodontic needs.

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