Get Salzmann Index Form

The Salzmann Index Form is designed to evaluate the presence and severity of malocclusion. This guide provides a straightforward approach to filling out the form online, ensuring you accurately represent the necessary information.

Follow the steps to complete the Salzmann Index Form online.

1. Press the ‘Get Form’ button to retrieve the Salzmann Index Form and open it in your preferred editor.
2. Begin by entering the patient's name, including the last, first, and middle initial as required. This information should be clearly articulated at the top of the form.
3. Next, provide the member number, date of birth, tax ID, and the date of assessment in their respective fields. Accurate details are crucial for proper record-keeping.
4. Fill in the referring dentist and orthodontist’s name. This section is important for the continuity of patient care.
5. Move to the ‘Handicapping Malocclusion Assessment Record’ section and assess intra-arch deviations. Record the number of affected teeth in the maxilla and mandible for each category such as missing, crowded, rotated, and spacing. Ensure to score accordingly.
6. In the interarch deviations section, score the anterior and posterior segments based on the provided instructions. Enter the number of affected maxillary teeth and score them appropriately.
7. Summarize the scores by calculating the total score for both intra-arch and interarch deviations. It's critical to maintain an accurate total for effective evaluation.
8. Finally, complete the description of the patient’s condition, diagnostic procedures, treatment plan, and any remarks that may be necessary for the orthodontist’s future reference.
9. After ensuring all information is correctly entered, save your changes, download the completed form, and share it with relevant parties if needed.

Complete your Salzmann Index Form online today and ensure accurate assessment of malocclusion.