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PRIOR AGREEMENT APPLICATION - DENTAL TREATMENTS 2026
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- Click ‘Get Form’ to open the PRIOR AGREEMENT APPLICATION - DENTAL TREATMENTS in the editor.
- Begin by entering the insured person’s surname, first name, and HENNER - GMC ID number in the designated fields.
- Fill in the patient’s surname, first name, date of birth, and sex. Ensure all information is accurate for processing.
- Indicate whether this application is related to an accident by selecting 'Yes' or 'No'. If 'Yes', attach a detailed report describing the accident.
- Complete the section for orthodontics if applicable, including anticipated treatment duration and relevant analysis values (Ricketts or Tweed).
- For dental prostheses, ensure you attach required documents such as dental radiographs and specify any devitalised or vital teeth.
- For periodontics and implantology applications, include necessary assessments and reports as outlined in the form.
- Finally, sign and date the application. Ensure your physician also signs and seals where indicated before submission.
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