Checklists for the Treatment Consult with the patient 

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Treatment Consult Packet- This packet includes all of the checklists and forms that should be studied when viewing the Treatment Consult Course.

Treatment Consult Checklist- This checklist summarizes all of the steps that should be completed by the New Patient Coordinator or Treatment Coordinator in the Treatment Consult.

New Patient Instructions- This sample of New Patient Instructions may be edited to fit the needs of the practice. It should be reviewed in detail with the patient and parent at the Treatment Consult.

MS Word  Document

Concerns Summary and Recommended Treatment- This Excel Spreadsheet lists all of the concerns, treatment recommendations, and calculates the treatment fee arrangements. It should be prepared by the doctor during the case work up, printed, and given to the patient at the Treatment Consult.

 MS Excel Spreadsheet

Truth In Lending Contract Template- This contract sample may be edited to meet the needs of the practice.

 MS Word  Document

Reimbursment Contract for Paid in Full- This sample fee contract is useful to calculate the amount of the fee that the patient should be reimbursed if the patient has paid for treatment in full and moves before treatment is completed.  

 MS Word  Document

Financial Coordinator Consultation Follow Up Duties- This form is a sample Job Description for the Financial Coordinator to follow up on financial arrangements after the Treatment Consultation.

 MS Word  Document

Acrobat Reader - To download, view and print the PDF Checklists you need to have Adobe Acrobat Reader Installed.