Related links
Pediatric and Adolescent Medical Record Review Tool
May 30, 2014 □ Dental referral should be done at 6, 9 Encounter forms or notes have a notation End of Pediatric and Adolescent Medical Record Review
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Dental Services Referral Form
Please check box below that best represents referral source: WIC private physician general dentist. Early Head Start well-child clinic pediatric dentist.
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Referrals - UW School of Dentistry - University of Washington
AGD Referral Form (PDF). 206-616-8545 (FAX). 206-685-8258 The Center for Pediatric Dentistry Pediatric Dentistry Referral Form (PDF). 206-543-0063 (FAX).
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