Get Dental Reward Certificate - D2obpdzg90ovgf Cloudfront

Completing the Dental Reward Certificate is a straightforward process that helps ensure you receive the points you deserve for your orthodontic care. This guide will walk you through the necessary steps to effectively fill out the form online, ensuring all required information is accurately provided.

Follow the steps to complete your Dental Reward Certificate online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your full name in the 'Patient Name' field, ensuring it matches your records with Dr. Patricia J. Panucci.
3. Take a moment to review your participation in the Beach Braces Rewards Program. Ensure that you understand how points are awarded for hygiene appointments, cavity-free visits, and the completion of recommended treatments.
4. In the following section, you will see three statements regarding your dental services. Mark each statement that applies to you by checking the corresponding box: 1) Dental cleaning and exam, 2) No cavities, 3) Requested dental treatment completed.
5. Once you have checked the appropriate boxes, have your dentist or hygienist complete the 'Dentist or Hygienist Signature' and 'Practice Name' fields to verify your participation and receipt of care.
6. Finally, write the date of completion in the 'Today’s Date' field to ensure that the certificate is valid and timely.
7. Review your filled form for accuracy before you save your changes, download it, print it, or share it as necessary.

Complete your Dental Reward Certificate online today to ensure you receive your rewards points!