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Quantity	Name	SKU	Each	Total
	Informed Consent - Multi-Area Treatment (English)		$10.00	$10.00
	Informed Consent for I.V. Sedation		$10.00	$10.00
	Conscious Sedation Informed Consent - Pediatric		$10.00	$10.00
	Forms in Spanish Package		$75.00	$75.00
	Informed Consent for Bone Regeneration		$10.00	$10.00
	Informed Consent for General Dentistry	IC-GEN	$10.00	$10.00
	Informed Consent for Endodontics	IC-ENDO	$10.00	$10.00
	Informed Consent for Implants		$10.00	$10.00
	HIPAA Privacy Practices Notice to Patients	HPA6	$5.00	$5.00
	"Annual Subscription to texdentlaw.com" Package		$195.00	$195.00
	Auxillary Employment Agreement		$25.00	$25.00
	Dentist Associate Emloyment Agreement		$75.00	$75.00
	Basic Emergency Equipment and Drugs		$10.00	$10.00
	Informed Consent for Extractions		$10.00	$10.00
	Conscious Sedation Informed Consent - Adult		$10.00	$10.00
	Informed Consent for Orthodontics - Long Form		$10.00	$10.00
	"All Informed Consent Forms" Package		$175.00	$175.00
	Informed Consent for Implants & Anesthesia - Long Form		$10.00	$10.00
	HIPAA Complaint Form	HPA3	$5.00	$5.00
	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.
	Consumer Information for Display		$1.00	$1.00
	Contract for Purchase & Sale of Dental Records	S-DRO	$50.00	$50.00
	Complete HIPAA Compliance Forms Package	HPAC	$20.00	$20.00
	HIPAA Employee Notice of Privacy Policies & Procedures	HPA5	$5.00	$5.00
	Informed Consent for Botox(tm) Injection(s)		$10.00	$10.00
	Gingivitis - Patient Education	PE1	$5.00	$5.00
	HIPAA Patient Acknowledgement of Receipt of Privacy Practices	HPA1	$5.00	$5.00

Subtotal	$921.00
Total	$921.00

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.