Da Form 3984 For use of this form see TB MED 250 proponent agency is Office of TSG 3 31 Check items in Column c to indicate treatment planned If sequence of treatment is other than that printed in column b use numbers 1 thru 10 in column c to show desired order SECTION I PLANNED TREATMENT AND SEQUENCE OF ACCOMPLISHMENT
DA Form 3984 Dental Treatment Plan SF 513 Medical Record Consultation Sheet SF 519B Radiologic Consultation Request Report SF 522 of the DA Form 3444 series see para 1 6c AR 40 2 LEFT SIDE OF FOLDER Form Number Form Title and Notes DA Form 5570 Health Questionnaire For Dental Treatment The DA Form 3984 Dental Treatment Plan may be used to record the treatment plan and to serve as a functional outline for dental treatment see figures 2 1 and 2 2 This form must be retained as a part of the patient s dental health record until the treatment plan has been accomplished or superseded
Da Form 3984
Da Form 3984
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For use of this form see TB MED 250 proponent agency is Office of TSG 3 31 Check items in Column c to indicate treatment planned If sequence of treatment is other than that printed in column b use numbers 1 thru 10 in column c to show desired order SECTION I PLANNED TREATMENT AND SEQUENCE OF ACCOMPLISHMENT
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DA Form 3984 Dental Treatment Plan SF 513 Medical Record Consultation Sheet SF 519B Radiologic Consultation Request Report SF 522 of the DA Form 3444 series see para 1 6c AR 40 2 LEFT SIDE OF FOLDER Form Number Form Title and Notes DA Form 5570 Health Questionnaire For Dental Treatment
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Health record is DA Form 3984 Dental Treatment Plan figure 2 7 This form is designed to serve as a functional outline for the accomplishment of complex dental treatment It provides a systematic approach to clinical dental care and aids in the achievement of optimum results in dental treatment Figure 2 7 DA Form 3984 Dental Treatment For use of this form see TB MED 250 proponent agency is Office of TSG 3 31 SECTION I PLANNED TREATMENT AND SEQUENCE OF ACCOMPLISHMENT 1 CONSULTATION DESIRED If yes complete Section III on reverse side L I N E C O D E a TYPE TREATMENT PLANNED SE QUENCE ACCOM PLISHED CHART 12 REMARKS OR INSTRUCTIONS RIGHT LEFT SECTION II
HOME FORM DA 3984 Back to FORM 30 votes Rate Me Form was filled out and downloaded 1 006 times already Fillable Form DA 3984 DENTAL TREATMENT PLAN FILL ONLINE EMAIL SHARE ANNOTATE FILL ONLINE FILL ONLINE Contents What is DA 3984 How to fill out DA 3984 FAQs about DA 3984 FILL ONLINE DA Form 3984 Dental Treatment Plan is a document used by the Department of the to outline and authorize dental treatment for military personnel The form captures important information about the patient s dental condition proposed treatment and any associated costs The form consists of sections where the dentist provides information about
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DIVISION C - DEPARTMENT OF DEFENSE APPROPRIATIONS ACT, 2022 The following is an explanation of the effects of this Act, which ma
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What is DA FORM 3984 DA FORM 3984 titled Dental Treatment Plan is an essential document used by military dental professionals It provides a clear and organized way to document the dental care and treatment plans for service members As an active form it plays a critical role in ensuring that personnel receive the appropriate dental care necessary to keep them healthy and mission ready U S DOD Form dod da 3984 DENTAL TREATMENT PLAN For use of this form see TB MED 250 proponent agency is Office of TSG YES CONSULTATION DESIRED If yes complete Section III on reverse side NO SECTION I PLANNED TREATMENT AND SEQUENCE OF ACCOMPLISHMENT Check items in Column c to indicate treatment planned
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Navy opens multiuse recreation center onboard San Nicolas Island > Commander, Navy Region Southwest > News Detail
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Da Form 3984 - [desc-13]