Forms Issued by the Health Authorities

– Accepting or re-accepting patients into continuing care

– Claiming continuing care fees

– Claiming fees for treatment

– Claiming referral and occasional treatment fees

– Accepting or re-accepting a child into capitation

– Claiming capitation fees and entry payments

– Claiming fees for treatment excluded from capitation

– Claiming referral and occasional treatment fees

– Accepting adults into continuing care when not seen by dentist or where no other fees claimed

– Begins continuing care payments

– Up to six patients on one form

– Dental care acceptance form and Treatment plan

– Gives acceptance into continuing care and treatment plan and estimate of cost to patient

– Gives general advice to patient

– Must be given to patients at acceptance into continuing care or when treatment is required

– Deals entirely with orthodontic procedures

i) section 1 – forms contract

section 2 – gives diagnostic and treatment information

ii) should be used for all orthodontic treatments under Item 32 of the scale of fees

– Orthodontic acceptance form and treatment plan

– Estimate where applicable

– Gives advice to patients

– Explanation of treatment

F.P.26

– Care and treatment summary

– the dental prescription form.

i) used only for NHS patients

ii) must be kept unstamped, unsigned and safe. (see Prescribing in Practice)

iii) can only use drugs in D.P.F.

– a receipt for payment of money for NHS treatment.

i) must be issued if no other form of receipt is available

ii) must be issued in cases where patient may be exempt, or partially exempt, and needs to be able to claim money back.