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January, 2023Dental CT Order Form Mass General Imaging Waltham 40 Second Avenue, Waltham, MA Phone: 7814876020 Fax: 7814876130Mass General Imaging Chelsea 80 Everett Avenue, Chelsea, MA Phone: 6178873500
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How to fill out dental ct order form
How to fill out dental ct order form
01
Obtain the dental CT order form from the dental office or healthcare provider.
02
Fill out the patient's information section, including name, date of birth, and contact information.
03
Provide details of the reason for the dental CT scan and any relevant medical history.
04
Indicate the preferred date and time for the appointment for the CT scan.
05
Sign and date the form to acknowledge consent for the procedure.
06
Submit the completed form to the healthcare provider or dental office for processing.
Who needs dental ct order form?
01
Patients who have been referred for a dental CT scan by a dentist or healthcare provider.
02
Dentists or healthcare providers who are ordering a dental CT scan for diagnostic or treatment planning purposes.
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What is dental ct order form?
The dental ct order form is a document used to request a dental CT scan.
Who is required to file dental ct order form?
Dentists or dental professionals who are requesting a dental CT scan are required to file the dental ct order form.
How to fill out dental ct order form?
To fill out the dental ct order form, the dentist or dental professional must provide patient information, reason for the scan, and any other requested details.
What is the purpose of dental ct order form?
The purpose of the dental ct order form is to request a dental CT scan for a patient.
What information must be reported on dental ct order form?
The dental ct order form should include patient information, reason for the scan, requested scan parameters, and any other relevant details.
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