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General Informed Consent:
Consent for General Dentistry
$10.00
General Informed Consent for Dentistry:
Includes blanks to fill in specific procedures to be performed. Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Extractions
$10.00
ldf.com ext1
Comprehensive informed consent for all tooth extractions.
Includes:
blanks to record blood pressure and pulse on date of extraction(s), as well as blanks for dentist signature and foreign language interpreter signature (if needed). Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for extractions, addresses patient expectations, and treatment alternatives.
Consent for Multiple Areas of Dentistry (
English
)
$10.00
Informed Consent for Multiple Areas of Dentistry (in English): Areas of treatment include Oral Surgery, Periodontics, Endodontics, and Crown & Bridge.
Also includes:
blanks to fill in blood pressure and pulse, as well as specific teeth on which procedures to be performed. Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Multiple Areas of Dentistry
(Spanish)
$10.00
Informed Consent for Multiple Areas of Dentistry (in Spanish): Areas of treatment include Oral Surgery, Periodontics, Endodontics, and Crown & Bridge.
Also includes:
blanks to fill in blood pressure and pulse, as well as specific teeth on which procedures to be performed. Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Crown & Bridge
$10.00
Consent for Crown & Bridge
: Includes blanks to fill in tooth numbers to be prepared and restored. Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for crowns and/or bridges, addresses patient expectations, and treatment alternatives.
Consent for Dentures
$10.00
Consent for Dentures:
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for complete dentures, addresses patient expectations, and treatment alternatives.
Consent for Nitrous Oxide Anesthesia
$10.00
Consent for Nitrous Oxide Anesthesia:
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Local Anesthetic
$10.00
Informed Consent for Use of Local Anesthetic: Includes blanks to record blood pressure and pulse.
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for I.V. Sedation
$10.00
ldf.com ivsed
Consent for I.V. Sedation: Includes blanks to record blood pressure and pulse on date of sedation procedure.
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Teeth Whitening
$10.00
ldf.com white
Informed Consent for Teeth Whitening: Comprehensive 4-page form.
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Botox(tm) Injection(s)
$10.00
Informed Consent for Botox(tm) Injection(s):
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.
Consent for Dental Treatment While Using Oral Bisphosphonates
$10.00
ldf.com bisph
Informed Consent for Dental Treatment While Using Oral Bisphosphonates.
Discloses the risks or hazards that could influence a reasonable person in making a decision to give or withhold consent for treatment, addresses patient expectations, and treatment alternatives.