Get the free Early Discontinuation of Orthodontic Treatment Request Form

THRIVE DENTAL AND ORTHODONTICS REQUEST FOR DISCONTINUATION OF ORTHODONTIC TREATMENT I, ___ (Patient OR parent/guardian of ___, if patient is a minor) do hereby request the discontinuation of further

How to fill out early discontinuation of orthodontic

How to fill out early discontinuation of orthodontic

1. Gather all the necessary documents and forms required for discontinuation of orthodontic treatment.
2. Review the terms and conditions stated in your orthodontic treatment agreement to understand the process and any potential consequences.
3. Contact your orthodontist or the orthodontic clinic to inform them about your decision to discontinue the treatment.
4. Schedule an appointment with your orthodontist to discuss the reasons for early discontinuation and any alternatives or recommendations they may have.
5. Fill out the early discontinuation form provided by your orthodontist or clinic.
6. Provide the required information requested in the form, including your personal details, treatment details, and reasons for discontinuation.
7. Review the completed form to ensure accuracy and completeness.
8. Submit the filled-out form to your orthodontist or clinic as per their instructions.
9. Follow any additional steps or instructions provided by your orthodontist or clinic regarding the discontinuation process.
10. Keep a copy of the submitted form for your records.

Who needs early discontinuation of orthodontic?

1. Early discontinuation of orthodontic treatment may be necessary for individuals who:
2. - Experience severe discomfort or pain during the treatment which cannot be effectively managed.
3. - Encounter unexpected financial difficulties that hinder their ability to continue the treatment.
4. - Have personal reasons or circumstances that require them to terminate the treatment prematurely.
5. - Face significant changes in their dental health or overall medical condition that make the orthodontic treatment unfeasible or unnecessary.
6. - Have completed the desired goal of the orthodontic treatment ahead of schedule.

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What is early discontinuation of orthodontic?

Early discontinuation of orthodontic refers to the process of terminating orthodontic treatment before the originally intended completion date, often due to various reasons such as patient choice, financial issues, or health concerns.

Who is required to file early discontinuation of orthodontic?

The treating orthodontist or dental provider is typically required to file for early discontinuation of orthodontic treatment.

How to fill out early discontinuation of orthodontic?

To fill out early discontinuation of orthodontic, providers must complete the designated form, providing details about the patient, treatment history, reasons for discontinuation, and any relevant medical or financial information.

What is the purpose of early discontinuation of orthodontic?

The purpose of early discontinuation is to formally document the termination of treatment, ensuring that all parties understand the reasons for discontinuation and to facilitate any necessary follow-up care.

What information must be reported on early discontinuation of orthodontic?

Information that must be reported includes the patient's personal details, treatment start date, reason for discontinuation, any potential health impacts, and signatures of the provider and patient.