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Back Figure 2-12.—Request for Medical/Dental Records or Information, DD Form 877 | Up Dental Volume 1 - Dentist training manual for military dentists | Next SUPPLY PROCEDURES |
permit, however, the record should be delivered to the
consulting provider with instructions to return it the
same way.
Do not jeopardize patient care or
unnecessarily inconvenience the patient.
HANDCARRYING FAMILY MEMBERS
DENTAL RECORD.When an adult patients
dental record is handcarried by someone other than the
patient (spouse or an adult family member), release of
the record must be authorized by the patient. Dental
records of minor children may be released to the
parent, sponsor, spouse, other adult family member, or
the childs legal guardian. In divorce cases, a childs
dental record may only be released to the parent who
has been awarded custody of the child by a court order.
COPIES OF DENTAL RECORDS.Excerpts
from or copies of dental records for the patient may be
approved by the treating dentist or DTF director.
Permanent Transfer to Ships or Stations
At the time of patient checkout from the DTF,
personnel that are responsible for the release of dental
records will ensure the following steps are completed.
Further guidance for permanent transfers is found in
MANMED, chapter 16.
If no dental record exists, construct a new dental
record following the instructions in this chapter
and MANMED. Have a dentist perform a T-2
dental examination.
Verify dental record.
Ensure patient has been processed for transfer.
Complete dental record chargeout.
Allow active duty members to handcarry their
dental record, unless the DTF or members
command determines it is not in the Navys or
memberss interest to do so. If the dental record
is not to be handcarried, forward it via certified
mail along with a DD Form 877, Request for
Medical/Dental Records Information, or place
dental record in the custody of authorized
personnel.
Temporary Dental Records
In certain cases, a DTF may require the
establishment of a temporary dental record, in addition
to the patients permanent dental record. Temporary
records are required to ensure the timely availability of
information that documents a current course of
treatment for a patient being seen in the DTF. An
example is a military member on temporary additional
duty (TAD) without his or her dental record who
requires emergency dental treatment.
CUSTODY OF TEMPORARY DENTAL
RECORD.The temporary dental record is
maintained by the DTF providing the current course of
treatment. When the treatment is complete or when the
patient returns to the location of the permanent dental
record, the patient may handcarry the record or the
custodian of the temporary record must forward it to
the custodian of the permanent record.
CONSTRUCTION OF TEMPORARY
DENTAL RECORD.The temporary dental record
must, at a minimum contain the following:
Privacy Act Statement, DD 2005
Dental Health Questionnaire, NAVMED 6600/3
Dental Treatment Form, EZ603A
If a dental record jacket is not used, care must be
taken to securely fasten any radiographs to the forms
comprising the temporary dental record.
DISPOSITION OF TEMPORARY DENTAL
RECORD.As soon as possible, the temporary
dental record must be merged with the permanent
dental record including all forms except the Privacy
Act Statement.
An entry must be made in the
permanent dental records most current dental
treatment form that the merger has occurred.
LOOSE TREATMENT FORMS.When loose
treatment forms are discovered, every effort should be
made to determine the present location of the dental
record. If reasonable search efforts do not locate the
dental record, retain loose treatment forms for a period
of 1 year. Upon expiration of the retention period,
destroy the forms locally according to paragraph six of
the standard identification code 6150 contained in
SECNAVINST 5212.5.
RETIREMENT OF THE DENTAL RECORD
Dental records should be verified and retired as
instructed in the section Inactive Records in this
chapter. Records should be retired to the National
Personnel Records Center, Military Personnel
Records, St. Louis, Missouri.
RELEASE OF INFORMATION
Information in the dental record is personal and is
considered privileged. Treatment records should not
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