Get Pre-evaluation Questionnaire Form - Rideau Orthodontic Mfg. Ltd.

Filling out the Pre-Evaluation Questionnaire Form for Rideau Orthodontic Mfg. Ltd. is an important step in initiating a case evaluation request. This guide will assist you in successfully navigating the form online with step-by-step instructions tailored to your needs.

Follow the steps to complete the form efficiently:

1. Click the ‘Get Form’ button to access the form and open it in your preferred digital editor.
2. Begin by entering the required information in the fields for the doctor's name and the patient's name. Ensure that you print clearly.
3. Select whether the case is new or ongoing by checking the appropriate box.
4. For patient information, input the patient's age and date of birth in the specified format (dd/mm/yy). Select the gender and provide the height.
5. Indicate the patient’s race by checking one of the options available or specifying another in the provided space.
6. In the dental records section, check all relevant boxes indicating the provided casts, wax bites, photographs, and x-rays.
7. If required, specify whether cephalometric tracing is needed by selecting yes or no.
8. For the treatment prognosis section, outline any existing problems if the casts are held in an ideal Class I relationship, along with the model classification and any remarks regarding wisdom teeth and dental hygiene.
9. Provide space shortage measurements along with details regarding overjet and overbite by indicating yes or no and filling in the specified measurements.
10. In the additional information section, include the patient’s concerns, airway examination details, and whether they are a mouth breather or snore.
11. Document any observations regarding temporomandibular joint symptoms along with observations on asymmetries of dental arches and body posture.
12. Finally, fill in your contact details, including an email address and office telephone and fax numbers.
13. Once all sections are completed, review the form for accuracy and clarity, then save your changes, download, print, or share the completed form as needed.

Complete your Pre-Evaluation Questionnaire Form online now to initiate your evaluation process with Rideau Orthodontic Mfg. Ltd.