-20 min late, no show after confirmation 1,2,3 times
D-Diagnosis - what is the problem?
Two part statement joined by phrase "related to"
Example;
→Class I light related to good home care or
Example;
→Class II moderate related to infrequent dental visits and abundance of calculus present; bone loss
Dentist may have you enter referral needs here
→⁺⁺Flag chart too ⁺⁺
, P-Plan - How to fix the problem
List procedure you have planned to perform for THIS day
Example;
→FMX, Plaque index, complete assessment, scale by quad.
Example;
→Complete debridement of max. arch with local anesthesia
I-Interventions - Putting the plan to action
Actual procedures completed on THIS day
Example;
→FMX, Plaque index. Assessment incomplete only performed IO/EO/perio exam and hard tissue
charting.
E-Evaluation - Did the plan work?
→Appointment went well
→Patient unhappy not able to complete assessment and will require extra visit.
→Next Visit; one week
→Recare; 6 months (insurance codes)
Signatures - °You must sign your notes with your full name.
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