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MCG School of Dentistry Quality Assurance Manual

Orthodontic Case Complete Appointment – Quality Assessment Check List

Discipline/Quality Assessment Area

Unacceptable

Additional Treatment Needed/Comments

 

 

 

Orthodontics:

 

 
  • Examination and Personal History

 

 
  • Diagnostic Aids

 

 
  • Diagnosis and Treatment Plan

 

 
  • Case Presentation/Consultation

 

 
  • Execution of Treatment Plan

 

 
  • Retention and Planned Recall

 

 
  • Evaluation of Treatment

 

 
  • Supervision of Auxiliaries

 

 

 

 

 

 

 

 

Discomfort:

 

 

 

 

 

Appropriateness of Care:

 

 

 

 

 

Other Comments:

 

 

 

 

 

 

 

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Patient Services
 School of Dentistry | Medical College of Georgia
 Please email comments, suggestions or questions to:
Linda Kimberly,

December 19, 2005