Patient Forms General Consent for Treatment Permission for Treatment of a Minor Authorization to Release Dental Information General Dental Release Informed Consent: Photographs Informed Refusal X-Ray Consent Withheld Release From Liability-Informed Refusal Against Dental Advice Local Anesthesia Tooth Removal Impacted Tooth Removal Surgical Procedure Endodontic (Root Canal) Treatment Intravenous Sedation Inhalation Sedation (Nitrous Oxide-Oxygen) General Periodontal Treatment Informed Refusal – Periodontal Treatment Periodontal Treatment: Non-Surgical or Referral Periodontal Scaling and Root Planing Amalgam “Fillings” Tooth Colored “Fillings” Prosthodontic Treatment – Crowns, Bridges, Veneers, Inlays and Onlays Prosthodontic Treatment – Removable Implants Home Whitening Office Whitening Request for Removal of Amalgam Orthodontic Treatment TMJD Treatment Video Records Bisphosphonates Panoramic Imaging X-Ray/Imaging Report New Patient- Practice Philosophy & Financial Policy Medical History Patient Registration COVID-19 Patient Screening
