Referral To Pedodontist
City, State ZIP
(or preferably print on letterhead)
October 4, 2006
City, State Zip
Dear Dr. Pedodontist:
I have referred [child's name] to you for comprehensive treatment.
Angel was new to us today. She is 6 years old. At her last dental office (Dr. ____) she had a prophy on 5/25/2011, and bitewings. We don’t have any copies of these.
We took two bitewing x-rays today, and gave Mom a set to take to you.
- Caries A, B, I, J, K, S, T; possibly more areas
- Angel reports occasional pain in S-T area
- Unsealed 3, 14, 19, 30
- Moderate crowding
Thank you for taking good care of Angel!