Get Interdepartmental Referral Form - Loma Linda University - Dentalclinics Llu
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How to use or fill out the Interdepartmental Referral Form - Loma Linda University - Dentalclinics Llu online
The Interdepartmental Referral Form at Loma Linda University Dental Clinics is essential for initiating referrals between departments. This guide will help users navigate the online form with ease by providing step-by-step instructions tailored to their needs.
Follow the steps to fill out the Interdepartmental Referral Form online.
- Press the ‘Get Form’ button to access the Interdepartmental Referral Form and open it in your editor.
- In the ‘Referring Department’ section, enter the name of the student or resident referring the patient, along with their supervising faculty name.
- Move to the ‘Patient Information’ section and fill in the patient’s full name and date of birth.
- Select the appropriate box under ‘Dental Student/Main Clinic’ to indicate which dental service is being referred (Grad Endo, Peds, OSR, or other).
- Clearly state the reason for the referral in the designated space provided.
- In the ‘Approval Signatures’ section, check all applicable boxes that describe the patient's needs (e.g., uncooperative patient, developmental disability, extensive treatment needed, etc.).
- Obtain the student or resident's signature and date the form in the associated fields.
- Ensure that the supervising faculty and/or referring dentist provide their signature and date as well.
- Review all entries for accuracy and completeness. Once confirmed, you may save changes, download, print, or share the completed form as needed.
Complete your documents online today for streamlined processing.
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During your time at Loma Linda University School of Dentistry, you will receive an excellent contemporary education filled with rich clinical experiences. However, it is the people who have been drawn to this unique environment of Christian education and mission who make Loma Linda University a special place.
Fill Interdepartmental Referral Form - Loma Linda University - Dentalclinics Llu
To view a form, click on one of the following links: General Forms, Patient Registration Form, Medical History Questionnaire, Graduate Orthodontic Clinic Forms. Referral Guides provide community physicians and clinic staff with the information needed to refer patients to LLUH for care. We provide referring physicians with a simple way to share information to improve patient care. With CareLink, there are easy, paperless referrals. Carlos M. Moretta, DDS to see: Oral and Maxillofacial Surgery Resident. The three dentists from Loma Linda University provided several services including cleanings, extractions, and fillings. " Please complete form in full, including physician signature. " Please include authorizations for all patients as needed, specifically.
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