Get Cbct/3d Imaging Referral Form - Bu
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How to fill out the CBCT/3D Imaging Referral Form - Bu online
Filling out the CBCT/3D Imaging Referral Form - Bu online involves a straightforward process designed to ensure accurate patient information and imaging requests. This guide offers step-by-step instructions to help users complete the form efficiently.
Follow the steps to accurately complete the form:
- Click ‘Get Form’ button to obtain the form and open it in the editing interface.
- Enter the patient information in the designated fields. Provide the patient’s name, date of birth, gender, address, city, state, zip code, telephone number, and email address. Ensure each entry is accurate to avoid delays.
- Fill in the current date and the appointment date and time, along with the consultation date. These details help in scheduling and tracking the patient’s care.
- In the referring doctor section, input the doctor's name, address, telephone number, and email address. Confirm that all information is correct, as this data is essential for communication.
- Specify the required exam by selecting one or more options. This may include areas such as implant sites, orthodontic assessments, or sinus assessments. For sections requiring further specification, provide the necessary details in the provided fields.
- Indicate your image data request preferences, whether you need prints of the region of interest or a CD with DICOM files. Clarity here is essential for the imaging team.
- Add any special instructions that may be relevant to the patient’s case. This section allows for specific requests that may assist in the imaging process.
- Review all the entered information to ensure everything is complete and accurate. Double-check for any spelling errors or missing information.
- Once you are satisfied with the completed form, you can save changes, download, print, or share the form as needed to submit it to the necessary parties.
Start filling out your CBCT/3D Imaging Referral Form - Bu online today.
To create a patient referral, include essential patient information, such as name and contact details. Clearly specify the service or treatment being recommended, along with any relevant background information. It’s important to be concise yet thorough, as this will help the specialist to understand the patient's needs right away. Ensure the referral includes the CBCT/3D IMAGING REFERRAL FORM - Bu for optimal clarity.
Fill CBCT/3D IMAGING REFERRAL FORM - Bu
Orange County Specialty Dental Group will include a CD Rom containing digital images of the CBCT along with i-Dixel 2.0. Software for the areas of interest. This examination produces a 2D image of all your teeth and jaws (including buried teeth), and is useful for planning. CBCT Referral Form. Title. REFERRAL FORM FOR CBCT SCAN – NUVO DENTAL (CR Diener Professional Corporation). Date: Ordering Dentist. 155 Remuera Road, Remuera. PLEASE CALL US AT TO SCHEDULE YOUR PATIENT. Area of interest: Mandible. Maxilla. Sample CBCT Scan Referral Form.
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