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Quantity	Name	SKU	Each	Total
	Consent for Nitrous Oxide Anesthesia	ldf.com nitrous	$10.00	$10.00
	Consent for Perio Prophylaxis	ldf.com perio	$10.00	$10.00
	Informed Consent for Orthodontics - Short Form		$10.00	$10.00
	Patient Dismissal Letter	dismissusa	$10.00	$10.00
	Informed Consent for Orthodontics - Long Form		$10.00	$10.00
	Informed Consent for Crown & Bridge	IC-C&B	$10.00	$10.00
	Informed Consent for Botox(tm) Injection(s)		$10.00	$10.00
	Chart Audit / Inventory Rule 108.8 Compliance		$10.00	$10.00
	Consent for Photography	ldf.com photo	$10.00	$10.00
	Informed Consent for Implants & Anesthesia - Long Form		$10.00	$10.00
	Informed Consent for Perio Prophylaxis		$10.00	$10.00
	Consent for Orthodontics - Long Form	ldf.com orthlng	$10.00	$10.00
	Refusal of Recommended Treatment		$10.00	$10.00
	Informed Consent for Treatment/Oral Bisphosphonates		$10.00	$10.00
	Patient Authorization to Release Dental Records		$10.00	$10.00
	Consumer Information for Display		$1.00	$1.00
	Informed Consent for Treatment/Oral Bisphosphonates		$10.00	$10.00
	"All Informed Consent Forms" Package		$175.00	$175.00
	Employment Agreement - Auxillary Staff		$25.00	$25.00
	Informed Consent for Botox(tm) Injection(s)		$10.00	$10.00
	Consent for Crown & Bridge	ldf.com c&b1	$10.00	$10.00
	Informed Consent for Fixed Prosthodontics		$10.00	$10.00
	Informed Consent for Teeth Whitening		$10.00	$10.00
	legaldentalforms.com"All Informed Consent Forms"		$175.00	$175.00
	Consent for Local Anesthetic	ldf.com local	$10.00	$10.00
	Informed Consent for General Dentistry	IC-GEN	$10.00	$10.00
	Custom Forms with Office Binder & CD	custombinder	$150.00	$150.00
In the box below, please type or paste the name and/or description for each of the 10 or more forms you wish to order (10 form minimum purchase). Also, in additon to the forms being ordered, please type below the doctor and/or office name and office address information to be inserted onto each form.

Subtotal	$746.00
Total	$746.00

Coupon Code:

If you have a coupon, enter the code and press recalculate

Any changes above should be verified by pressing 'Recalculate' before clicking on 'Checkout'.

Secure, on-line payment via PayPal: At checkout, you will be directed to PayPal which will provide options for secure payment by either the credit card you prefer (VISA, Mastercard, Discover, & AMEX), or through your PayPal account.
A PayPal account is NOT required.

Instructions for Downloading Forms
Once successfully ordered, you will immediately receive an e-mail containing the links to download your purchased forms.

To download the forms you recently ordered, click the URL link provided in the e-mail for each item (or copy and paste the entire URL address into your browser's address field). Once opened or downloaded to your browser, you may save the forms to your computer.

You will have up to 10 days to download the forms you have ordered, with a total of 10 retries.

Forms are in Adobe Acrobat " .pdf " format.

If you have any difficulty with either downloading or opening your forms, please contact Boyd W. Shepherd at (281) 304-1000 or boyd@legaldental.com.