(b) Each work authorization must contain the following information: (1) The name and address of the dental laboratory to which it is directed; (2) the case identification; (3) a specification of the materials to be used; (4) a description of the work to be done and, if necessary, diagrams thereof; (5) the date of issue; and (6) the signature and address of the dentist or other dental practitioner issuing the work authorization. A separate work authorization must be issued for each patient of the dentist or other dental practitioner for whom a dental laboratory service is to be performed.
(c) Every work authorization must be made in duplicate with the original being delivered to the dental laboratory to which it is directed and the copy being retained in the office of the issuing dentist or other dental practitioner. A work authorization must be saved for a period of two years from its date of issue.
Note: WV Code updated with legislation passed through the 2012 1st Special Session