Facebook tracking pixel
Back to Templates
Orthodontic Specialist
10-15 minutes

Dental Referral Letter

The Referral Letter to Dentist template by s10.ai is crafted for healthcare professionals seeking to refer patients for advanced dental assessment and treatment. This template features sections for patient details, medical and dental history, and specific referral reasons, ensuring thorough communication between medical providers. It is perfect for drafting detailed and structured referral letters to dentists, promoting smooth collaboration in patient care. Leverage this template with s10.ai, the AI medical scribe, to swiftly produce professional referral letters customized to each patient's requirements.

2,268 uses
4.3/5.0
D
Dr. Emily Thompson
Template Structure

Organized sections for comprehensive clinical documentation

[Date]
[Referring Clinician's Name]
[Referring Clinician's Practice Name]
[Referring Clinician's Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]
Dear [Dentist's Name],
Re: Recommendation for Dental Assessment and Care
I am writing to refer my patient, [Patient's Full Name], [Patient's Date of Birth], for a dental evaluation and any necessary treatment. Below, I have provided relevant clinical information to assist in your assessment and management.
- Reason for Referral: [describe the specific dental issues or concerns that prompted the referral] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
- Medical History: [provide a brief summary of the patient's relevant medical history, including any chronic conditions or previous surgeries] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
- Medications: [list current medications and herbal supplements the patient is taking] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
- Allergies: [mention any known allergies] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
- Social History: [describe relevant social history, such as smoking, alcohol use, or occupation] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
- Previous Dental History: [provide any relevant information about the patient's past dental treatments or issues] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
I would appreciate it if you could provide a detailed report of your findings and any treatment plans you propose. Please do not hesitate to contact me if you require any further information.
Thank you for your attention to this matter.
Sincerely,
[Referring Clinician's Name]
[Referring Clinician's Title]
[Referring Clinician's Practice Name]
Sample Clinical Note

Example of completed documentation using this template

October 15, 2023
Dr. Emily Johnson  
Smile Bright Orthodontics  
123 Braces Lane  
Springfield, IL, 62701  
(555) 123-4567  
emily.johnson@smilebright.com  
Dear Dr. Robert Smith,
Re: Referral for Dental Evaluation and Treatment
I am writing to refer my patient, John Doe, born on March 5, 2005, for a dental evaluation and any necessary treatment. Below, I have provided relevant clinical information to assist in your assessment and management.
- Reason for Referral: John has been experiencing persistent discomfort in his lower molars, which may require further evaluation for potential cavities or other dental issues.
- Medical History: John has a history of asthma, managed with inhalers, and no previous surgeries.
- Medications: Currently taking Albuterol inhaler as needed.
- Allergies: No known allergies.
- Social History: John is a non-smoker and is currently a high school student.
- Previous Dental History: John had braces removed last year and has had regular dental check-ups every six months.
I would appreciate it if you could provide a detailed report of your findings and any treatment plans you propose. Please do not hesitate to contact me if you require any further information.
Thank you for your attention to this matter.
Sincerely,
Dr. Emily Johnson  
Orthodontist  
s10.ai
Clinical Benefits

Key advantages of using this template in clinical practice

  • This comprehensive dental referral template is designed to streamline communication between healthcare providers, ensuring a seamless transition of care for patients requiring dental evaluation and treatment. By incorporating high-search healthcare keywords, this template facilitates efficient documentation of essential clinical information, including medical history, current medications, and previous dental treatments. Clinicians can easily customize sections to include specific details such as allergies, social history, and the reason for referral, enhancing the accuracy and relevance of the referral. Adopting this template not only improves patient outcomes through precise information sharing but also strengthens professional collaboration between referring clinicians and dental specialists. Explore this template to enhance your practice's referral process and ensure optimal patient care.
Frequently Asked Questions

Common questions about this template and its usage

Ready to transform your practice?

Join thousands of clinicians already using S10.AI to reduce administrative burden and improve patient care.

Cookie Preferences

We use cookies to enhance your browsing experience, analyze site traffic and personalize content.

Dental Referral Letter