Get the free Orthodontic Review Form

This form is used to submit documentation for comprehensive orthodontic treatment coverage for patients with identifiable syndromes that result in severe craniofacial deformities. It requires the submission of specific images and photographs to determine eligibility for benefits, which are limited to certain conditions.

How to fill out orthodontic review form

How to fill out orthodontic review form

1. Obtain the orthodontic review form from your orthodontist's office or website.
2. Read the instructions provided on the form carefully.
3. Fill in your personal information, including your name, date of birth, and contact details.
4. Provide information about your dental history, including any previous orthodontic treatments.
5. List any current dental issues or concerns you have.
6. Complete any sections asking about your medical history, including allergies and current medications.
7. Answer any questions about your dental hygiene habits, such as how often you brush and floss.
8. Review your answers for accuracy and completeness.
9. Sign and date the form where indicated.
10. Submit the completed form to your orthodontist's office either in person or online.

Who needs orthodontic review form?

1. Individuals seeking orthodontic treatment to assess their dental alignment.
2. Parents of children who may require braces or other orthodontic appliances.
3. Patients returning for follow-up appointments after previous orthodontic work.
4. Those experiencing dental issues that may benefit from orthodontic evaluation.

For pdfFiller’s FAQs

How can I manage my orthodontic review form directly from Gmail?

The pdfFiller Gmail add-on lets you create, modify, fill out, and sign orthodontic review form and other documents directly in your email. Click here to get pdfFiller for Gmail. Eliminate tedious procedures and handle papers and eSignatures easily.

How can I modify orthodontic review form without leaving Google Drive?

By combining pdfFiller with Google Docs, you can generate fillable forms directly in Google Drive. No need to leave Google Drive to make edits or sign documents, including orthodontic review form. Use pdfFiller's features in Google Drive to handle documents on any internet-connected device.

Can I sign the orthodontic review form electronically in Chrome?

Yes, you can. With pdfFiller, you not only get a feature-rich PDF editor and fillable form builder but a powerful e-signature solution that you can add directly to your Chrome browser. Using our extension, you can create your legally-binding eSignature by typing, drawing, or capturing a photo of your signature using your webcam. Choose whichever method you prefer and eSign your orthodontic review form in minutes.

What is orthodontic review form?

An orthodontic review form is a document used by orthodontists to assess a patient's orthodontic needs, treatment options, and progress.

Who is required to file orthodontic review form?

Orthodontic review forms must be filed by orthodontic practitioners or dental professionals managing patients undergoing orthodontic treatment.

How to fill out orthodontic review form?

To fill out an orthodontic review form, practitioners should accurately complete all sections regarding patient information, treatment history, clinical observations, and recommendations.

What is the purpose of orthodontic review form?

The purpose of the orthodontic review form is to communicate the patient's orthodontic status, document treatment plans and outcomes, and facilitate coordination of care.

What information must be reported on orthodontic review form?

The form should report patient demographics, medical history, dental history, examination findings, treatment objectives, and any relevant radiographs.