U.S. DOD Form dod-da-3984 DENTAL TREATMENT PLAN For use of this form see TB MED 250 proponent agency is Office of TSG. YES CONSULTATION DESIRED If yes complete Section III on reverse side NO SECTION I - PLANNED TREATMENT AND SEQUENCE OF ACCOMPLISHMENT Check items in Column c to indicate treatment planned. If sequence of treatment is other than that printed in column b use numbers 1 thru 10 in column c to show desired order.
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How to fill out the Da Form 3984 online
Completing the Da Form 3984 online can streamline your dental treatment plan submissions. This guide provides step-by-step instructions to help you navigate through the necessary fields and sections of the form effectively.
Follow the steps to complete the Da Form 3984 with ease.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin with Section I, where you will indicate the planned treatment and sequence of accomplishment. Check the items in Column c to denote the treatment planned. If the sequence differs from the printed order, number your choices accordingly.
- In the area designated for charting, only chart missing teeth and the treatment to be accomplished. Avoid marking existing pathologies or restorations.
- Complete any additional remarks or instructions in the designated space. Use this section to clarify the treatment or to describe any actions that do not fit into the standard charting.
- Proceed to Section II, where you will fill out patient identification details including sex, race, grade, organization, last name, first name, middle initial, date of birth, and identification number.
- If necessary, move on to Section III for consultation requests. Here, indicate if a consultation is desired by checking the appropriate boxes.
- Finally, review all entered information for accuracy. Once completed, you can save your changes, download the form, print it, or share it as needed.
Complete your Da Form 3984 online today for a smoother dental treatment process.
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