Você está na página 1de 1

DATA:______/_____/______

PLANEJAMENTO PARA DENTÍSTICA

ACADÊMICO :_________________________________________________________RA:___________________
AUXILIAR :____________________________________________________________RA:___________________
PACIENTE :______________________________________________________PRONT.:____________________

PROCEDIMENTO

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

MATERIAL UTILIZADO

___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
___________________________________________ ____________________________________________
_______ ____________________________________________
___________________________________________ ____________________________________________
SISTEMA DE AVALIAÇÃO
___________________________________________ ____________________________________________
___________________________________________ ______________________
PLANEJAMENTO_________________________( ) OBSERVAÇÕES
_________________________
BIOSSEGURANÇA________________________( ) ____________________________________________
MATERIAL COMPLETO____________________( ) ____________________________________________
UNIFORME_____________________________( ) ____________________________________________
CONHECIMENTO________________________( ) ____________________________________________
____________________________________________
TÉCNICA RESTAURADORA ____________________________________________
____________________________________________
ISOLAMENTO/ ANESTESIA _________________( )
ESCULTURA_____________________________( ) NOTA FINAL DO ALUNO:____________________
PONTO DE CONTATO_____________________( )
COR___________________________________( ) PROFESSOR RESPONSÁVEL:__________________
ACABAMENTO/POLIMENTO________________( )

Você também pode gostar