Maryland Code, Health Occupations § 4-403

(1) Be on the form that the Board requires;

(2) Be signed by a licensed dentist who requests the work; and

(3) Contain the information required by this section.

(1) The name and address of the dental laboratory to do the work;

(2) Identification of the patient by name or number;

(3) The date on which the work authorization form was completed;

(4) A description of the work to be done, including diagrams if necessary;

(5) A specification of the type of dental materials to be used; and

(6) The name and license number of the dentist who requests the work.

(1) Completes in duplicate the subcontracted work authorization form that the Board requires; and

(2) Complies with the record keeping requirements of § 4-404 of this subtitle.

(1) An approved standard work authorization form; and

(2) An approved standard subcontracted work authorization form that is of a color different from the standard work authorization form.

(1) Is on the form that the Board requires or a reasonably equivalent form; and

(2) Otherwise meets the requirements of this subtitle.