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Additional Authorized Party Form Please list any additional authorized individuals who you give permission to receive information and/or schedule appointments for the patient. The patients mother
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How to fill out orthodontic screening form
How to fill out orthodontic screening form
01
Obtain the orthodontic screening form from the orthodontist or dental office.
02
Fill in the patient's personal information such as name, address, contact details, and date of birth.
03
Answer questions about the patient's dental and medical history.
04
Provide information about any current dental concerns or issues.
05
Sign and date the form to confirm that all information provided is accurate.
Who needs orthodontic screening form?
01
Anyone who is considering orthodontic treatment or is seeking to assess their orthodontic needs should fill out an orthodontic screening form.
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What is orthodontic screening form?
The orthodontic screening form is a document used to evaluate an individual's need for orthodontic treatment. It collects information regarding the patient's dental and medical history to determine if a referral for further evaluation is necessary.
Who is required to file orthodontic screening form?
Typically, individuals seeking orthodontic treatment or a referral for such treatment are required to file the orthodontic screening form, which can include patients, their guardians, or referring dental professionals.
How to fill out orthodontic screening form?
To fill out the orthodontic screening form, provide accurate personal information, including the patient's name, date of birth, contact details, dental history, and any relevant medical history. Follow the specific instructions provided on the form to ensure all sections are completed.
What is the purpose of orthodontic screening form?
The purpose of the orthodontic screening form is to gather essential information to assess whether a patient requires orthodontic evaluation. It serves as a preliminary tool for orthodontists to decide on the necessity of further diagnostic procedures.
What information must be reported on orthodontic screening form?
The information that must be reported on the orthodontic screening form includes patient demographics (name, age, contact information), dental history, existing dental issues, any relevant medical conditions, and previous orthodontic treatments, if applicable.
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