Get Orthodontic Referral Form

Filling out the Orthodontic Referral Form online is a crucial step in facilitating access to orthodontic treatment. This guide provides clear and supportive instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully fill out the form online.

1. Click the ‘Get Form’ button to obtain the Orthodontic Referral Form and open it in your selected editor for online completion.
2. Begin by filling in the referring practitioner’s information, including their name, address, and practice stamp if available. Make sure to use clear and legible text.
3. Next, enter the patient details. This includes the patient's name, date of birth, address (including postcode), age, and contact telephone numbers. Ensure that all details are accurate.
4. Address the questions regarding the patient's readiness and dental fitness for orthodontic treatment. Indicate whether the patient is motivated, dentally fit, and has good oral hygiene. These sections are critical for referral assessment.
5. In the reason for referral section, select the appropriate options regarding the patient's condition or treatment plan. Include any relevant radiographs that support the referral by checking the appropriate boxes.
6. Identify the main presenting problem by ticking the respective column. Use the clear spaces to indicate the normal patient pathway for each problem as outlined in the form.
7. As the final step, review all information for accuracy. Once verified, you can save your changes, download a copy for your records, print the form, or share it as needed.

Complete the Orthodontic Referral Form online today to ensure a smooth referral process.