Document Reference No.

:
WORK INSTRUCTION BatStateU-WI-HSD-08-A

Document Title: Issuance of Dental Certificate

1.0 Objective
To have a common procedure on issuance of dental certificate

2.0 Scope
This shall apply to all patients who secure dental certificate

3.0 Procedure

PROCESS FLOW RESPONSIBILITY DETAILS

START

Nurse Retrieving the School Dental Examination

Retrieval of Record Record (BatStateU-FO-HSD-11) of the
patient.
.

Nurse Patient who secure dental certificate should

Refer to Dentist be referred to dentist.

Dentist Assessment of oral condition and purpose of

Assessment securing Dental Certificate.

Dentist Dental Certificate (BatStateU-CE-20) is

Issuance and Releasing issued.

Dentist Record the assessment on the School Dental

Documentation Examination Record (BatStateU-FO-HSD-
11), the purpose of issuing the Dental
Certificate and log to BatStateU-LB-HSD-21.

END

4.0 Reference Documents

BatStateU-QMS:
BatStateU-PM-01:
BatStateU-FO-HSD-11:
BatStateU-CE-20:
BatStateU-LB-HSD-21:
Quality Management System Manual
Control of Documented Information
School Dental Examination Record
Dental Certificate
Dental Certificate/Referral/Recommendation/Prescription Issued

Prepared by: Karla-Mae C. Alvar, RN

Date:

Reviewed by: Dr. Expedito V. Acorda Approved by: Atty. Luzviminda C. Rosales
Date: Date:

April 25, 2018 Rev. 01 Page 1 of 1