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Get the free DENTAL X-RAY / RADIOLOGY REFERRAL FORM

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How to fill out dental x-ray radiology referral

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How to fill out dental x-ray radiology referral

01
Obtain the patient's information such as name, date of birth, and contact information.
02
Include the reason for the referral and any relevant medical history.
03
Specify the type of x-ray needed (e.g. bitewing, periapical, panoramic).
04
Provide any additional instructions or preferences for the radiology technician.
05
Sign and date the referral before sending it to the radiology department.

Who needs dental x-ray radiology referral?

01
Dentists who require further diagnostic imaging to assess oral health conditions.
02
Patients who are referred by their dentists for specialized x-ray imaging.
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Dental x-ray radiology referral is a request for a patient to undergo x-ray imaging of the teeth and surrounding structures by a radiology specialist.
Dentists or dental specialists who believe that x-ray imaging is necessary for proper diagnosis and treatment.
Dental x-ray radiology referral forms can be filled out by providing patient information, reason for referral, specific x-ray imaging required, and relevant medical history.
The purpose of dental x-ray radiology referral is to obtain detailed imaging of dental structures to aid in diagnosis and treatment planning.
Patient demographics, reason for referral, specific x-ray imaging required, referring provider information, and relevant medical history.
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