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CT Dental Scan Appointment Form - Lake Forest Hospital - lfh 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal information in the 'Patient Information' section. Fill in your last name, first name, date of birth, and contact numbers.
- Indicate whether a stent is required for your procedure by selecting the appropriate option. If applicable, provide details for results delivery to your physician.
- In the 'Physician Information' section, enter the referring practitioner's last name, first name, NPI number, and fax number. Ensure all details are accurate for seamless communication.
- Review any notes or special instructions regarding symptoms or diagnoses. This is crucial for proper documentation and billing.
- Finally, sign and date the form at the bottom before submitting it to registration on your appointment day.
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