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Page Title: DENTAL CLASSIFICATION TAPE
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RECORD CATEGORY TAPE
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Dental Volume 1 - Dentist training manual for military dentists
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Figure 2-10.—NAVMED 6600/3, Dental Health Questionnaire

CATEGORY TAPE” box, according to the following categories listed below: Record Category Active duty military (This includes reserves on active duty over 30 days) Reserve military, not on active duty Family  member(s) Retired All others Color  Tape Blue Red Yellow Green Black 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 Question- naires  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. 2-16

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