Get the free ORTHODONTIC REFERRAL V1 template

Please complete and send to only ONE of the below (multiple referrals will be rejected by all providers):orthodontist 2 The Crescent, Plymouth PL1 3ABTel: 01752 222 444 Plymouth Orthodontics 60 Lower

How to fill out orthodontic referral v1 template

How to fill out orthodontic referral form v1

1. To fill out an orthodontic referral form v1, follow these steps:
2. Begin by providing the patient's personal information, including their name, date of birth, and contact details.
3. Specify the reason for the referral, such as crooked teeth, overbite, underbite, or other orthodontic concerns.
4. Indicate any previous orthodontic treatment the patient has received, if applicable.
5. Include relevant medical history, including any known allergies, medications being taken, and relevant health conditions.
6. Write down the referring dentist's information, including their name, contact details, and practice name.
7. Provide any additional relevant information or notes that may assist the orthodontist in assessing the patient's case.
8. Ensure all sections of the form are completed accurately and clearly.
9. Double-check the form for any missing information or errors before submission.
10. Once the form is complete, either submit it electronically or print and send it to the orthodontist's office as per their preferred method.
11. Keep a copy of the completed referral form for your records.

Who needs orthodontic referral form v1?

1. Orthodontic referral form v1 is typically needed by dentists or dental professionals who wish to refer a patient to an orthodontist for specialized orthodontic treatment or evaluation.
2. Primarily, dentists who identify orthodontic issues beyond their scope of practice may need to fill out this form to connect their patients with orthodontic specialists.
3. Additionally, patients with orthodontic concerns who would like to seek a second opinion or explore different treatment options may request their dentist to fill out this referral form.
4. Ultimately, anyone seeking specialized orthodontic care from an orthodontist would require an orthodontic referral form v1 to initiate the referral process.
5. It is important to note that the specific requirements for needing an orthodontic referral form v1 may vary depending on the policies and guidelines of the particular dental or orthodontic practice.

What is ORTHODONTIC REFERRAL V1 Form?

The ORTHODONTIC REFERRAL V1 is a Word document that should be submitted to the specific address to provide some information. It needs to be completed and signed, which may be done manually, or by using a certain solution such as PDFfiller. This tool lets you fill out any PDF or Word document directly from your browser (no software requred), customize it depending on your needs and put a legally-binding electronic signature. Right away after completion, the user can send the ORTHODONTIC REFERRAL V1 to the relevant person, or multiple ones via email or fax. The template is printable too due to PDFfiller feature and options proposed for printing out adjustment. In both digital and in hard copy, your form will have got neat and professional appearance. You may also save it as the template for later, without creating a new file from the beginning. Just amend the ready document.

Instructions for the ORTHODONTIC REFERRAL V1 form

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How should you fill out the ORTHODONTIC REFERRAL V1 template

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What is orthodontic referral form v1?

The orthodontic referral form v1 is a document used by dental professionals to refer patients to orthodontic specialists for further evaluation and treatment.

Who is required to file orthodontic referral form v1?

Dental professionals such as general dentists or pediatric dentists are required to file the orthodontic referral form v1 when they determine a patient needs orthodontic evaluation.

How to fill out orthodontic referral form v1?

To fill out the orthodontic referral form v1, the referring dentist must provide patient information, clinical findings, treatment history, and any specific concerns regarding the patient's orthodontic needs.

What is the purpose of orthodontic referral form v1?

The purpose of the orthodontic referral form v1 is to facilitate communication between general dentists and orthodontic specialists, ensuring that patients receive appropriate and timely orthodontic care.

What information must be reported on orthodontic referral form v1?

The information that must be reported includes the patient's demographic details, dental and medical history, specific orthodontic concerns, and any previous treatments related to orthodontics.