Get the free Graduate Orthodontic Referral Form

A referral form used by dentists and physicians to refer patients for orthodontic evaluation and treatment, including patient information and orthodontic concerns.

How to fill out graduate orthodontic referral form

How to fill out graduate orthodontic referral form

1. Begin by entering the patient's personal information including their name, age, and contact details.
2. Fill in the referring dentist's information such as name, practice address, and contact number.
3. Specify the reason for the referral, detailing any concerns regarding the patient's dental alignment or orthodontic needs.
4. Include the patient's medical history, highlighting any past dental treatments or relevant health issues.
5. Attach current dental records, including X-rays or photographs, if applicable.
6. Sign and date the referral form before submission.

Who needs graduate orthodontic referral form?

1. Dentists who identify orthodontic issues in their patients and recommend specialized treatment.
2. General practitioners who are involved in comprehensive dental care for patients requiring orthodontic evaluation.
3. Patients experiencing misalignment of teeth or jaw who need a professional assessment for orthodontic treatment.

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What is graduate orthodontic referral form?

The graduate orthodontic referral form is a document used by dental professionals to refer patients to orthodontic specialists for further evaluation and treatment.

Who is required to file graduate orthodontic referral form?

Dental professionals, including general dentists and specialists, are required to file the graduate orthodontic referral form when referring patients for orthodontic care.

How to fill out graduate orthodontic referral form?

To fill out the graduate orthodontic referral form, provide the patient's personal details, dental history, the reason for referral, and any relevant clinical findings.

What is the purpose of graduate orthodontic referral form?

The purpose of the graduate orthodontic referral form is to ensure that orthodontic specialists receive all necessary information regarding a patient’s dental condition for effective assessment and treatment planning.

What information must be reported on graduate orthodontic referral form?

The form must report the patient's demographic information, medical and dental history, specific concerns, and any previous treatments or interventions related to orthodontics.