ACTS Production Summary - CU Class of 2014 - Spring affiliation 2014

Use this online form to record the treatment you provide at your ACTS clinic

Complete one form for EVERY patient.

If you're tabbing from one field to the next while doing something else, please look at the screen when you stop to enter a number. If you just count taps of the tab key without looking, you may enter a stainless steel crown when you meant to enter a sedative filling.

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Diagnostic and Preventive Procedures

    Please only enter one type of exam for this patient visit.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Perio Procedures

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Primary Tooth Procedures

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Operative Procedures (permanent teeth)

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Endodontic Procedures

    If you didn't obturate today, please scroll down to the "Office visits" section of this form and enter today's patient visit there! (I added this field later, so it's not nested directly below here, the way the removable visit is.)
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Oral Surgery Procedures

    If you didn't actually provide one of these procedures, but this was a surgery related visit, please scroll down to the "Office visits" section of this form and enter today's patient visit there! (I added this field later, so it's not nested directly below here, the way the removable visit is.)
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Removable Procedures

    If you didn't deliver a prosthesis today, please use the "Prosth records visit" field, located just below the space where you're reading this text right now.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Fixed Procedures

    If you didn't cement a restoration today, please scroll down to the "Office visits" section of this form and enter today's patient visit there! (I added this field later, so it's not nested directly below, the way the removable field was nested.)
    This is a required question
    This is a required question
    This is a required question

    Office visits

    This is a required question
    This is a required question
    This is a required question
    This is a required question