RECORD CATEGORY TAPE

Immediately below the retirement year tape box is a similar box that should be used to indicate the record category. Use 1/2-inch wide, bright-colored tape in strips approximately l-inch long. Attach the tape in the space provided and extend the tape around the edge of the jacket to the back. All dental records should be identified with colored tape in the "RECORD

CATEGORY TAPE" box, according to the following categories listed below:

DENTAL CLASSIFICATION TAPE

Color-coded dental classification tapes are no longer used on the upper right-hand corner on the inside back cover of the Dental Record Jacket.

IDENTIFICATION OF FORMS

It is imperative that all forms documenting patient care contain adequate data to identify the patient and permit filing of the forms in the dental record. All data elements in the dental examination and treatment forms should be completely filled out. All other forms filed in the dental records should, at a minimum, contain the following data in the identification block:

Patient's FMP and sponsor's SSN.

Patient's name (last, first, middle initial).

Sponsor's branch of service (e.g., Army, Navy, or Air Force) and patient's status (e.g., family member or retired).

ARRANGEMENT OF FORMS

Prescribed forms will be filed in the dental record in the following order. The forms will be arranged in top to bottom sequence; like-numbered forms will be grouped together with the most recent form placed on top of each previous form, unless otherwise specified below.

INSIDE FRONT COVER OF DENTAL RECORD JACKET

Forms should be filed in the inside front cover of the dental record jacket as follows:

1. Unmounted radiographs in envelopes.

2. Sequential bitewing radiograph.

3. Panographic or full-mouth radiographs.

Front of Dental Record Jacket Center Page

Forms should be filed in the front of the dental record jacket center page as discussed in the following paragraphs:

(NAVMED 6600/3)\Dental officers, civilian dentists, and auxiliary personnel providing direct patient care must ensure that each patient has a completed, current Dental Health Questionnaire, in his/her dental treatment record before performing an examination or providing dental treatment. The NAVMED 6600/3 (fig. 2-10) must be filled out and signed by each patient. This must be reviewed, dated, and signed by the first dentist who conducts the examination or dental treatment. For minors, i.e., under the age of consent or majority in the applicable jurisdiction, the parent or guardian must fill out the form and sign in the patient's signature block of the question, using his or her name and not the child's name.

Each dental care provider must indicate, in the dental treatment section of the EZ603A that the questionnaire has been reviewed and updated by the patient. Dentist must also annotate on the EZ603 in the "O" objective block, sections marked "HQ dated," "Reviewed," and "HQR Finding."

During annual dental exams, patients need only to review, date, and sign the current questionnaire if health status has not changed. Whenever a significant change in medical history or health status occurs, a new questionnaire must be filled out, dated, and signed.

The initial and all later Dental Health Questionnaires are permanently maintained in the Dental Treatment Record. For conditions that require medical clarification, use the SF 513 (Consultation Sheet). Document the consultation on the EZ603-Dental Exam Form and in the Summary of Pertinent Findings section of the NAVMED 6600/3. BUMED Instruction 6600.12 provides guidance for the Dental Health Questionnaire.

BACK OF DENTAL RECORD JACKET CENTER PAGE

On this page of the dental record jacket, place all Dental Exam Forms, EZ603s (Plan "P" side up) in reverse chronological order.

Figure 2-10.\NAVMED 6600/3, Dental Health Questionnaire.