Get the free ORTHODONTIC REFERRAL FORM:

Orthodontic Referral Patient Name___ Age ___ Phone: ___ Parents Name: ___ Special Health Concerns:___ Patient Insurance Information: ___The patient is being referred for:Clinical Findings: General

How to fill out orthodontic referral form

How to fill out orthodontic referral form

1. Gather necessary information such as patient's personal details, dental history, and reason for referral.
2. Fill out patient's demographic information accurately including name, age, contact details.
3. Provide detailed information about patient's dental history, any previous treatments, and current issues.
4. Clearly state the reason for referral and specify any specific concerns or requirements.
5. Include any relevant diagnostic records such as X-rays, photographs, or models if available.
6. Sign and date the referral form before submitting it to the orthodontic specialist.

Who needs orthodontic referral form?

1. Orthodontic referral form is needed by dentists or dental specialists who are referring a patient to an orthodontic specialist for further evaluation and treatment.
2. Patients who have been recommended by their dentist or orthodontist to seek consultation from an orthodontic specialist also need to fill out this form.

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What is orthodontic referral form?

Orthodontic referral form is a document used by dentists to refer patients to an orthodontist for orthodontic treatment.

Who is required to file orthodontic referral form?

Dentists who believe their patients may benefit from orthodontic treatment are required to file the orthodontic referral form.

How to fill out orthodontic referral form?

To fill out the orthodontic referral form, dentists need to provide patient information, reason for referral, and any relevant dental records.

What is the purpose of orthodontic referral form?

The purpose of orthodontic referral form is to facilitate communication between dentists and orthodontists, ensuring patients receive appropriate treatment.

What information must be reported on orthodontic referral form?

The orthodontic referral form must include patient's name, age, reason for referral, dentist's contact information, and any relevant dental records.