Treatment Refusal

Forms for Informed Treatment Refusal:
Two forms - Treatment & Radiographs

<tr>

Informed Refusal of Radiographs
$10.00
Informed Refusal of Radiographs
TSBDE Rule 108.7 requires that Texas dentists maintain a written informed consent signed by the patient.
Rule 108.8(c)(2), (4), and (5) state that
"(c) Further, records must include documentation of the following when services are rendered:...
(2) Findings and charting of clinical and radiographic oral examination," which includes periodontal examination.
(4) Treatment plan, recommendation, and options;
(5) Treatment provided;..."
Rule 108.8(c)(12) states that
"(12) When any of the items in paragraphs (1) - (11) of this subsection are not indicated, the record must include an explanation why the item is not recorded."

Informed Refusal of Recommended Treatment
$10.00
Informed Refusal of Recommended Treatment
TSBDE Rule 108.7 requires that Texas dentists maintain a written informed consent signed by the patient.
Rule 108.8(c)(2), (4), and (5) state that
"(c) Further, records must include documentation of the following when services are rendered:...
(2) Findings and charting of clinical and radiographic oral examination," which includes periodontal examination.
(4) Treatment plan, recommendation, and options;
(5) Treatment provided;..."
Rule 108.8(c)(12) states that
"(12) When any of the items in paragraphs (1) - (11) of this subsection are not indicated, the record must include an explanation why the item is not recorded."

Informed Refusal of Periodontal Treatment/Therapy
$10.00
Informed Refusal of Periodontal Treatment/Therapy:
TSBDE Rule 108.7 requires that Texas dentists maintain a written informed consent signed by the patient. Rule 108.8(c)(2), (4), and (5) state that
"(c) Further, records must include documentation of the following when services are rendered:...
(2) Findings and charting of clinical and radiographic oral examination," which includes periodontal examination.
(4) Treatment plan, recommendation, and options;
(5) Treatment provided;..."
Rule 108.8(c)(12) states that
"(12) When any of the items in paragraphs (1) - (11) of this subsection are not indicated, the record must include an explanation why the item is not recorded."