TX HHS Form 3108. Dental Report

The TX HHS Form 3108, Dental Report, is a crucial tool for determining treatment needs for individuals referred to dental care. This form helps counselors gather essential information about the patient's dental health, allowing them to authorize necessary examinations and treatments.

The report requires specific information, including the patient's date of birth, social security number, reported disability, and reason for referral. The dentist must complete an examination and treatment record, using a charting system that includes ADA codes, descriptions of services, estimated fees, and materials used. This section is critical, as it determines whether definitive dental care can proceed.

This form should be used when referring patients to dental care services through the Texas Health and Human Services Division for Rehabilitation Services (DRS). The report's instructions emphasize the importance of completing all applicable items and returning the form for treatment authorization. By using this form, healthcare professionals can ensure that patients receive the necessary dental care while also streamlining the referral process.