[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-284176-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-284176-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","dental-clearance-form-south-texas-bone-and-joint-institute","Dental Clearance Form - South Texas Bone and Joint Institute","","This document provides a formal Dental Clearance Form used by the South Texas Bone and Joint Institute under the supervision of Dr. Siraj Sayeed. It is specifically designed to ensure that patients preparing for surgery have undergone a comprehensive oral health assessment to identify and address any potential infections before their pre-operative appointment. Dentists are required to evaluate the presence of oral infections and indicate the necessity of further treatment, ensuring a safe medical environment for the surgical procedure. By documenting these clinical findings, the form facilitates communication between dental professionals and the orthopedic institute, ultimately prioritizing patient safety and reducing risks associated with operative procedures. The form must be completed by the attending dentist and faxed directly to Dr. Sayeed's office to be reviewed during the patient's mandatory pre-operative clinical consultation.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/dental-clearance-form-south-texas-bone-and-joint-institute/284176/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/dental-clearance-form-south-texas-bone-and-joint-institute/284176.png","ImageObject",442,249,{"name":42,"@type":43},"McGucket","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the purpose of the Dental Clearance Form?","Question",{"text":63,"@type":64},"The form serves as a pre-operative requirement to ensure a patient is free of oral infections before undergoing surgery at the South Texas Bone and Joint Institute.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Who is responsible for completing this form?",{"text":68,"@type":64},"The patient's dentist must complete the form, detailing the presence of any infections or required future treatments, and fax it to Dr. Siraj Sayeed's office.",{"name":70,"@type":61,"acceptedAnswer":71},"When must this form be available?",{"text":72,"@type":64},"The completed form must be available for review at the patient’s pre-operative appointment with Dr. Sayeed.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},284176,1791109285,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":22},1236954412713,"https://us-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","DENTAL CLEARANCE FORM  \nSouth Texas Bone & Joint Institute Dr. Siraj Sayeed  \n210-696-2663 Office  \n210-696-2665 Fax  \nPLEASE FAX TO DR. SAYEED ONCE COMPLETED  \n*This form must be completed and available for review at the patient’s pre-operative appointment with Dr. Sayeed.  \nPATIENT NAME:    \nDENTIST NAME:    \nDATE:    \nPlease check ONE  \n Patient HAS NO oral infections at time of dental visit.  \n Patient HAS oral infection at time of dental visit.  \nPatient requires further dental treatment. (Please list)  \n_________________________________________________________________________  \n_________________________________________________________________________  \nSIGNATURE:","cbCaid2QlCjuTUul","https://ap.wps.com/l/cbCaid2QlCjuTUul","pdf",78388,"English","# Dental Clearance Form\n## Patient and Dentist Information\n## Oral Health Assessment\n## Dental Treatment Requirements","[{\"question\":\"What is the purpose of the Dental Clearance Form?\",\"answer\":\"The form serves as a pre-operative requirement to ensure a patient is free of oral infections before undergoing surgery at the South Texas Bone and Joint Institute.\"},{\"question\":\"Who is responsible for completing this form?\",\"answer\":\"The patient's dentist must complete the form, detailing the presence of any infections or required future treatments, and fax it to Dr. Siraj Sayeed's office.\"},{\"question\":\"When must this form be available?\",\"answer\":\"The completed form must be available for review at the patient’s pre-operative appointment with Dr. Sayeed.\"}]","Dental Clearance Form - South Texas Bone and Joint Institute | PDF",1789628393]