To use this search, begin typing keywords in the search box below and click search. Press "Reset" to start over. To browse alphabetically, click a letter.
Browse Alphabetically:

ALLA B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Search the Schedule:

Provides record of patient appointments. May now be found in CMS (or current database).

Official Copy: Any Clinic 
Retention: 6 years after end of calendar year
Disposition Method: Shred

Tracks student and faculty assignment to individual clinics and provides clinic coverage information. May act as attendance record of students assigned to the clinic.

Official Copy: Any Clinic
Retention: Until end of quarter
Disposition Method: Shred

Provides record of gold inventory and amount of gold used in dental procedures. May include Gold Log, which includes student name, patient name, date and amount of gold used in procedure.

Official Copy: Any Clinic
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Provides complete documentation of examination, diagnosis and treatment for each patient receiving dental care including: periodontal, orthodontal, oral surgery, endodontic treatment, or procedures such as dental implants which require long term tracking. Charts may include: Chart Routing Record, X-Rays logs, Admitting Record, Dental Insurance Questionnaire, Problem and Treatment Lists and Plans, Progress Notes/Treatment Record (UW-D-3), Health History Questionnaire, Fees Statement, Request for Radiographic Examination, etc. NOTE: As part of the teaching curriculumn, graduate students are required to perform recall visits on previous patients throughout the patient's life. Frequently, this means that a patient who received treatment in Graduate Periodontics or Graduate Prosthodontics might be called back many years, even decades after their initial treatment. Once the patient is deceased, the chart will be considered closed.

Official Copy: Clinical Services: Patient Records
Retention: Patient deceased
Disposition Method: Shred

Other Copy: Any Dental Clinic sending patient charts to Clinical Services: Patient Records
Retention: Send to Clinical Services: Patient Records

 A record of all requests for payment submitted to Medicaid, DSHS, or insurance companies. May include copies of applicable patient chart notes, procedure coding sheets, patient bill, etc.

Official Copy: Any Dental Office receiving insurance payments
Retention: 6 years after end of fiscal year
Disposition Method: Shred

A record of patient charges. Used to generate patient billing for individual payment. May include copies of applicable patient chart notes, procedure coding sheets, patient bill, etc.

Official Copy: CMS Management
Retention: 6 years after end of fiscal year
Disposition Method: Shred

 

Provides complete documentation of examination, diagnosis and treatment for each patient receiving dental care including: periodontal, orthodontal, oral surgery, endodontic treatment, or procedures such as dental implants which require long term tracking.  Charts may include: Chart Routing Record, X-Rays logs, Admitting Record, Dental Insurance Questionnaire, Problem and Treatment Lists and Plans, Progress Notes/Treatment Record (UW-D-3), Health History Questionnaire, Fees Statement, Request for Radiographic Examination, etc.

Official Copy: Clinical Services: Patient Records
Retention: 10 years after last treatment
Disposition Method: Shred / delete

Other Copy: Any Dental Clinic sending patient charts to Clinical Services: Patient Records
Retention: Send to Clinical Services: Patient Records after last contact

Provides a record of questionnaires or preliminary screening examinations of patients not accepted for admittance to a clinic. May include Admitting Report, Health History Questionnaire, and Progress Notes. Screening records of accepted patients become part of Patient Chart.

Official Copy: Any Clinic
Retention: 1 year after patient not accepted
Disposition Method: Shred

Provides record of each dispensed x-ray, prescription drug, set of dentures, etc. Includes Daily Script Journal.  Maintained as per RCW 69.41.042.

Official Copy: Any Clinic
Retention: 6 years after end of calendar year
Disposition Method: Shred

 

A record of refunds made for overpayment by dental patients or insurance companies.

Official Copy: Clinical Services: Accounting and Patient Accounts Office
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Official Copy: Any Clinic requesting patient funds
Retention: 6 years after end of fiscal year
Disposition Method: Shred

Contract outlining the treatment plan between patient and clinician. Includes correspondence regarding treatment, payment plans, any notes, and all amendments to the contract.

Official Copy: Any Clinic
Retention: 6 years after termination of contract
Disposition Method: Shred