STATDDS - Front Office Toolkit
Ready-to-use forms for your front office, including our sleep screening questionnaire, insurance verification form, home sleep test liability form, informed consent forms for treatment, and CPAP intolerance form.
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Download the following forms
Download the following forms
- CPAP Intolerance Form
- Fee for Service Payment Policy Agreement
- Informed Consent for Oral Appliance Therapy
- Letter of Medical Necessity – RX for oral appliance – Template 1
- Letter of Medical Necessity – RX for oral appliance – Template 2
- Letter to Physician into New Service
- Medical Insurance Verification of Eligibility
- Medicare and Medical Billing Checklist
- Monitor Instructions for the Patient
- Patient Liability Form Template
- Requesting Sleep Reads
- RIP Belt Size Chart
- Sample Bruxism Report
- Sample Sleep Physician Read
- Sleep Letter to Dr. — Template 1
- Sleep Letter to Dr. — Template 2
- Sleep Monitor Patient Log
- Sleep Screening Questionnaire
- Step by Step Guide to Dental Sleep Apnea
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