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- Click ‘Get Form’ to open the 3984 form in the editor.
- Begin with Section I, where you will check items in Column C to indicate the planned treatment. If your sequence differs from what is printed in Column B, use numbers (1 through 10) in Column C to show your desired order.
- In Section II, provide patient identification details such as sex, race, grade, and full name. Ensure accuracy for proper record-keeping.
- If a consultation is desired, complete Section III by checking the appropriate boxes for the type of consultation needed. Add any remarks if necessary.
- Finally, fill out Section IV with consultant remarks and recommendations. Initial after each entry and identify it by number for clarity.
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People also ask
What is the dental form?
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What is a dental form?
The forms provide information on dental home and current oral health status, and what oral health care services were delivered during the dental visit. These services include diagnostic and preventive services, counseling, restorative and emergency care, and referral to a specialist for care.