Diagnostic and treatment form is an essential part of the case data which is received from the doctor. A case cannot be processed without properly filled diagnostic and treatment form. 

This form provides all the inputs regarding the patient, the kind of malocclusion which needs treatment and the course of treatment to get that correction done. 

Apart from the above mentioned information, it also provides general information about the doctor. 

It also provides a unique case identification number which is assigned to the case when it is received and entered into our system. 

The form is divided into three different parts:

Part 1 provides the general information regarding patient and doctor.

Part 2 provides the information regarding initial teeth position in the arch and inter relationship of teeth with the opposing arch.

Part 3 provides the detailed treatment plan.

Download sample diagnostic & treatment form