Periodontal Risk Report
Use this template to report on patient document submissions.
Description#
Who has completed a periodontal risk assessment form?
View the score, submission date and time, as well as the patient name and age, and the submitting provider.
Sample#

Actions#
Request this template for your ICE Health Systems environment.
Provide feedback about this template.
Details#
| Version | Origin / Contributors | |
|---|---|---|
| 1 | University of Michigan | Attribution 4.0 International |