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3929 Bagless Avenue St. Louis, MO 63125 EMAIL: lab@perioprotect.com EMAIL Digital Printing: 3D@perioprotect.com PHONE: 3144740467Perio Protect LABORATORY FAX:8885112308Perio Tray Prescription Form
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How to fill out perio tray prescription form
How to fill out perio tray prescription form
01
Start by identifying if the patient is a suitable candidate for a perio tray.
02
Gather all necessary information about the patient including their medical history and current oral health condition.
03
Fill out the patient's personal information on the prescription form such as name, address, and contact details.
04
Specify the type of perio tray needed (e.g. upper arch, lower arch, or both) and any additional instructions from the dentist.
05
Include the desired medication to be used with the perio tray and the frequency of use.
06
Sign and date the prescription form before submitting it to the lab for fabrication.
Who needs perio tray prescription form?
01
Patients who have been diagnosed with gum disease and are looking for a non-invasive treatment option.
02
Patients who have difficulty maintaining good oral hygiene and need help with managing their periodontal condition.
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What is perio tray prescription form?
Perio tray prescription form is a document used to prescribe custom-fitted trays for the delivery of medication to the periodontal pockets.
Who is required to file perio tray prescription form?
Dentists or dental professionals are required to file the perio tray prescription form.
How to fill out perio tray prescription form?
To fill out the perio tray prescription form, provide patient information, medication details, tray specifications, and any other relevant information.
What is the purpose of perio tray prescription form?
The purpose of the perio tray prescription form is to ensure accurate prescription and delivery of medication for periodontal treatment.
What information must be reported on perio tray prescription form?
The perio tray prescription form must include patient details, medication dosage, tray specifications, and prescribing dentist information.
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