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City ___ State ___ Zip ___
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Email Address___DOB___SS#___
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Name ___ Relation
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How to fill out referring dentist initial perio
How to fill out referring dentist initial perio
01
Obtain the referring dentist's contact information including name, address, phone number, and dental practice name.
02
Record the patient's information such as name, date of birth, and reason for referral.
03
Fill out the referring dentist's initial perio by documenting the patient's current oral health status, any relevant medical history, and recommended treatment plan.
04
Include any relevant diagnostic data such as x-rays or photographs.
05
Ensure that the form is signed and dated by both the referring dentist and the receiving dental provider.
Who needs referring dentist initial perio?
01
Any patient who has been referred to a periodontist or other dental specialist by their regular dentist.
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What is referring dentist initial perio?
The referring dentist initial perio is a form used to report the initial periodontal assessment conducted by a referring dentist.
Who is required to file referring dentist initial perio?
The referring dentist who conducted the initial periodontal assessment is required to file the referring dentist initial perio.
How to fill out referring dentist initial perio?
The referring dentist should fill out the referring dentist initial perio form with the necessary information regarding the initial periodontal assessment.
What is the purpose of referring dentist initial perio?
The purpose of referring dentist initial perio is to document and report the initial periodontal assessment findings conducted by the referring dentist.
What information must be reported on referring dentist initial perio?
The referring dentist must report detailed information about the initial periodontal assessment, including probing depths, attachment levels, bleeding on probing, and other relevant findings.
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