Step-By-Step Manual for Dentists
New volunteers should submit a Volunteer Dentist Application to the Smiles for Success (SFS) national office. Smiles sends a welcome package with all necessary forms for your patient’s treatment. (These forms are also available for download on the website).GUIDELINES
- Volunteers will keep dental records of each SFS patient they treat.
- Volunteers will submit a report of the patient’s ledger with regular fees that were written off.
- Volunteers will submit a Participant Release Form, along with “Before and After” photos to the SFS national office upon completion of treatment.
- Volunteers will contact the Director of Practice Management with any problems or questions regarding dental treatment or participants.
Patient Documents
- Treatment Plan and Consent Form
- Lab Submission Form
- Participant Release Form
- Participant Evaluation Form
Prior to Treatment
Step 1. The SFS National office will work with Affiliate programs in your area to identify patients in need.Step 2. Once patients complete the screening process, SFS will send you eligible patient applications that includes basic background information about your patient, and their purpose for treatment.
Step 3. Review the patient application and notify the SFS office if you would like to accept the patient.
Step 4. The SFS National Office will contact the Affiliate program, who will assist the patient with setting up their first appointment and arrange their transportation.
Treatment Begins
Step 5. During the first appointment, you will perform a screening of the patient to include full mouth photos and x-rays.Step 6. Upon completion of the screening, you will create a treatment plan for the patient. Please fill out the following forms: The first two forms are signed by both patient and dentist. All forms need to be emailed to: board@secure.smilesforsuccess.org or faxed to the SFS National Office at (850) 484-8762 for approval.
Step 7. Once the patient signs the consent and agreement forms, you may begin phase one of treatment to include any initial procedures related to hygiene, dental cleaning, disease removal, or emergency extraction. Please take “Before” pictures.
Step 8. Upon review of the Treatment Plan, the SFS Office will contact you to let you know how to proceed with the next phase. If the treatment plan and lab fees have been approved, dental care can begin.
After Treatment
Step 9. Once treatment is complete, please take “After” pictures. Please ensure the patient completes and signs the following release form for our Success Story Showcase:Step 10. Please email high-resolution photos, evaluations, and a short success story to the SFS Office at cp@secure.smilesforsuccess.org to allow us to advertise your great work and provide hope to other women in our local communities!
