Get Download Cbct Request Form Here. - University Of Oklahoma ...

Filling out the Download CBCT Request Form at the University of Oklahoma is an important step in obtaining cone beam volumetric imaging services. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the CBCT request form.

1. Press the ‘Get Form’ button to access the form and open it in your document editor.
2. Begin by filling out the patient information section. Provide the patient's name, address, city, state, zip code, telephone number, email address, and date of birth. Ensure that each field is completed accurately as this information is crucial for processing the request.
3. Next, indicate the appointment date and time if applicable, or leave it blank for the college's office use. This helps in scheduling the necessary appointment based on the information provided.
4. In the services requested section, mark the appropriate ADA codes and check any relevant services required. Be sure to include details regarding the specific sites or any special instructions related to the imaging requests.
5. Fill in the referring doctor's details, including their name, address, and telephone number. This information is vital for the coordination of care and communication between healthcare providers.
6. Finally, check the certification box to confirm that the imaging study is ordered by a licensed dentist. This is an essential step in ensuring compliance with healthcare regulations.
7. Once you have completed all sections, you can save your progress, download the filled-out form, print a hard copy if needed, or share it based on your requirements. Ensure you keep a copy for your records.

Complete the Download CBCT Request Form online now to initiate the process for your imaging services.