PRIOR AGREEMENT APPLICATION - DENTAL TREATMENTS 2026

1. Click ‘Get Form’ to open the PRIOR AGREEMENT APPLICATION - DENTAL TREATMENTS in the editor.
2. Begin by entering the insured person’s surname, first name, and HENNER - GMC ID number in the designated fields.
3. Fill in the patient’s surname, first name, date of birth, and sex. Ensure all information is accurate for processing.
4. Indicate whether this application is related to an accident by selecting 'Yes' or 'No'. If 'Yes', attach a detailed report describing the accident.
5. Complete the section for orthodontics if applicable, including anticipated treatment duration and relevant analysis values (Ricketts or Tweed).
6. For dental prostheses, ensure you attach required documents such as dental radiographs and specify any devitalised or vital teeth.
7. For periodontics and implantology applications, include necessary assessments and reports as outlined in the form.
8. Finally, sign and date the application. Ensure your physician also signs and seals where indicated before submission.

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