Medical clearance form for dental 2026

1. Click ‘Get Form’ to open the medical clearance form for dental in the editor.
2. In Section 1, the dentist should complete the Dental Treatment Plan by providing details about the proposed treatment.
3. Next, indicate any patient conditions that may require special considerations. This is crucial for ensuring safe treatment.
4. If prophylactic antibiotic treatment is necessary, follow the current AHA guidelines and specify the protocol and prescription in the designated area.
5. Once Section 1 is completed, sign and date it before sending it to the physician.
6. The physician will then complete Section 2 by assessing if the patient is healthy enough for treatment. They should initial 'Yes' or 'No' accordingly.
7. The physician must also determine if prophylactic antibiotic treatment is required and provide their recommendations if different from what was suggested by the dentist.
8. Finally, both parties should sign and date their respective sections before faxing back to ensure a smooth exchange of information.

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