Aao Transfer Form ≡ Fill Out Printable PDF Forms Online

Aao Transfer Form – Fill Out and Use

The Aao Transfer Form is the best way to transfer students from one school to another. It has been around for over a decade, which means it's reliable and not likely to go away anytime soon.

The perfect place to get access to and work with this form is here. Our straightforward PDF editor can help you prepare your PDF within minutes. Any system you pick, whether a PC, laptop, smartphone, or tablet, can be used.

Aao Orthodontic Transfer Form Details

Aao Transfer Form is a new website that allows anyone to start an online business. We provide all the necessary tools for you to be able to run your own business without having any prior experience. All you have to do is register and select your desired product or service which will then take you through the signup process. The only thing we require from our customers is their email address, password, and name of their company so they can identify themselves as unique individuals on our site.

Here is some data that may be useful in case you are seeking to determine just how long it'll require you to fill out aao transfer form and just how many PDF pages it includes.

Question	Answer
Form Name	Aao Transfer Form
Form Length	3 pages
Fillable?	Yes
Fillable fields	87
Avg. time to fill out	18 min 13 sec
Other names	aao form, aao transfer form fillable, aao orthodontic transfer form, aao transfer

Form Preview Example

AAO TRANSFER FORM

PATIENT IN ACTIVE TREATMENT

Date

From

Phone (

)

Fax (

)

Patient's name

Birth date

Age

Sex

Social Security #

Phone (

)

Responsible party

Relationship:

Home address

City

State/Province

Zip code

ANALYSIS (Including significant history & TMD)

PATIENT/PARENT CONCERNS RE: TX

SPECIAL HEALTH OR HISTORY CONCERNS

TREATMENT PLAN (Including chronology of treatment rendered)

APPLIANCES

Appliance (type, manufacturer, type of bracket–metal or non-metal, and variations)

Date bands and/or brackets placed: Max

Mand

Bonding Agent

Cementing Agent

Current archwire size and type: Max

Mand

Extraoral type and dates initiated

Hours requested

Intraoral elastics, dates initiated, size and direction

Hours requested

Removable appliance type and dates initiated

Hours requested

PATIENT COOPERATION

Oral hygiene

Headgear

Elastics

Appointments

Broken appliances

Patient's attitude toward treatment

Suggestions for patient motivation

ACTIVE TX TIME ESTIMATES Original

Remaining

% of active treatment completed

ACTIVE TREATMENT RECOMMENDATIONS

RETENTION AND THIRD MOLAR RECOMMENDATIONS

ADDITIONAL COMMENTS

©American Association of Orthodontists 1999 Transfer – Active 5/00 Reviewed 09/09

FINANCIAL

Closed

Open End (Fixed)

Other

Fees: Active

Extras

Terms

Third party payment

Total charges before transfer

Total amount paid before transfer

Unpaid amount still owed transferring office

Balance of original quoted fee not yet charged

or overpaid at transfer

TRANSFER OF RECORDS (ENTER DATE)

Dates of our: Records

Casts

Articulator type

Cephalograms Tracings

Intraoral radiographs

Facial photographs

Intraoral photographs

Transferring	Duplicate	Initial
	Original	Progress

Check appropriate status of records

Record duplicates available upon request at extra charge Records enclosed Yes No

Under separate cover Yes No

Yes

Signature: __________________________________________________Date_______________________

(Orthodontist)

PATIENT RECORDS RELEASE AUTHORIZATION

When a patient moves, or, for other reasons, there is a necessity to change orthodontists during the course of ongoing orthodontic treatment, it is highly advantageous for all involved parties that the transfer be as prompt and convenient as possible. Of paramount importance is the identification of an orthodontist who will accept the patient and successfully complete the treatment.

The American Association of Orthodontists represents over ninety percent of the orthodontic specialists in the U.S. and Canada. Your current doctor is a member and will assist you in finding a qualified orthodontist.

It is necessary that your records be transferred to assure that the receiving orthodontist is knowledgeable of your orthodontic condition(s), orthodontic treatment goals, the current treatment plan, and related financial arrangements. To facilitate the transfer of these records, it is necessary that you complete the following:

I authorize ___________________________________________ to release all records of

(Orthodontist's Name)

__________________________________ for the purpose of continuation of treatment by another orthodontist.

(Patient's Name)

Signature: __________________________________________________________Date_______________________

(Patient or Guardian)

Transfer – Active 5/00

Reviewed 09/09

Print Name ________________________________________

Relationship to Patient _______________________________

How to Edit Aao Transfer Form

The filling in the aao transfer form fillable is quite quick. Our experts made sure our software is easy to understand and helps complete virtually any document in a short time. Below are several steps you'll want to follow:

Step 1: To begin with, click the orange "Get form now" button.

Step 2: Now you are going to be within the file edit page. It's possible to add, enhance, highlight, check, cross, insert or erase fields or phrases.

Provide the data demanded by the system to fill in the file.

You need to complete the ANALYSIS (Including significant, APPLIANCES, Appliance (type, Date bands and/or brackets placed:, Mand, Bonding Agent, Cementing Agent, Current archwire size and type: Max, Mand, Extraoral type and dates initiated, Hours requested, Intraoral elastics, Hours requested, Removable appliance type and dates, Hours requested, PATIENT COOPERATION, Oral hygiene, Headgear, Elastics, Appointments, Broken appliances, and Patient's attitude toward treatment field with the requested information.

Type in all details you may need within the section Patient's attitude toward treatment, Suggestions for patient motivation, ACTIVE TX TIME ESTIMATES Original, Remaining, % of active treatment completed, ACTIVE TREATMENT RECOMMENDATIONS, © American Association of, and Transfer – Active 5/00 Reviewed.

Please record the rights and responsibilities of the parties in the FINANCIAL, Closed, Open End (Fixed), Other, Fees: Active, Extras, Terms, Third party payment, Total charges before transfer, Total amount paid before transfer, Unpaid amount still owed, Balance of original quoted fee not, or overpaid at transfer, TRANSFER OF RECORDS (Enter date), Dates of our: Records, Casts, Articulator type, Cephalograms, Tracings, Intraoral radiographs, and Facial photographs field.

Finalize by analyzing the following fields and typing in the pertinent details: (Orthodontist), Signature:, PATIENT RECORDS RELEASE, and When a patient moves.

Step 3: Hit the Done button to save your form. Now it is obtainable for transfer to your gadget.

Step 4: To protect yourself from any headaches in the long run, you should get up to several duplicates of the form.

Aao Transfer Form – Fill Out and Use

Aao Orthodontic Transfer Form Details

Form Preview Example

How to Edit Aao Transfer Form

Aao Transfer Form isn’t the one you’re looking for?

Related Documents

Related Resources