Get Request Form For Opg Buddy Scheme Radiograph - Surreyldc Org

Filling out the Request Form for the OPG Buddy Scheme Radiograph can seem daunting, but this guide will help you navigate each section with ease. By following these instructions, you will ensure that all necessary information is accurately provided for your request.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to access the Request Form for OPG Buddy Scheme Radiograph and open it in your preferred online editor.
2. Begin by filling in the name of the referring dentist in the designated box. This information is important for identifying the request origin.
3. Next, enter the practice name and address, ensuring that this is the location where the referring dentist operates.
4. Provide the postcode, telephone number, and email address of the referring practice. The email address will be used for sending a digital copy, so ensure it is accurate.
5. In the patient’s details section, fill in the patient's name, date of birth, address, postcode, and telephone number. This information is essential for accurate identification and communication regarding the patient's care.
6. In the medical history/observations section, include any relevant details that may affect the radiography request.
7. Fill in the patient’s medical practice details, including the name, address, postcode, and telephone number. This helps to provide a comprehensive medical background.
8. Articulate your clinical reasons for requesting the radiographic exposure in the designated field. Be concise and specific.
9. Indicate whether you intend to refer this patient to the DARS service for an extraction. If not, provide reasons for requesting instead through the Buddy service in the provided space.
10. Lastly, review your entries for accuracy. Save any changes you have made to the form. You then have options to download, print, or share the completed request form as needed.

Take action today by completing the Request Form online to facilitate the care your patient needs.