Get the free Orthodontic Referral Form - Align&Smile
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Orthodontic Referral Form Docklands Dental Referral Center / Align & Smile Ltd Tel: 020 7538 9990 Email: info alignandsmile.co.referring Dentist name & address:Patient's Name:DOB:Age:Address:Postcode:
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How to fill out orthodontic referral form
How to fill out orthodontic referral form
01
Start by obtaining a copy of the orthodontic referral form from your orthodontist.
02
Fill in the patient's personal information, including their name, date of birth, and contact details.
03
Provide details about the referring dentist or healthcare professional, including their name, contact information, and practice details.
04
Specify the reason for referral, such as the specific orthodontic issues or concerns.
05
Include any relevant medical or dental history that may impact the orthodontic treatment.
06
Attach any necessary supporting documentation, such as X-rays or dental records.
07
Make sure to sign and date the referral form before submitting it to the orthodontist.
Who needs orthodontic referral form?
01
Orthodontic referral forms are needed by patients who require specialized orthodontic treatment and are being referred to an orthodontist by their dentist or healthcare professional. These forms help ensure proper communication and transfer of relevant patient information between the referring provider and the orthodontist.
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What is orthodontic referral form?
The orthodontic referral form is a document used to refer a patient to an orthodontist for evaluation and treatment.
Who is required to file orthodontic referral form?
Orthodontic referral forms are typically filed by dentists, orthodontists, or other healthcare providers who identify the need for orthodontic treatment.
How to fill out orthodontic referral form?
To fill out an orthodontic referral form, one must provide the patient's information, reason for referral, relevant medical history, and any supporting documentation.
What is the purpose of orthodontic referral form?
The purpose of an orthodontic referral form is to facilitate communication between healthcare providers and ensure that patients receive appropriate orthodontic care.
What information must be reported on orthodontic referral form?
Generally, an orthodontic referral form should include the patient's name, contact information, reason for referral, relevant medical history, and any relevant diagnostic images.
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