Before proceeding with any dental treatment or services, we want to ensure that you have a clear understanding of the procedures involved and give your explicit consent for us to proceed. Your comfort and informed decision are essential to us, and we aim to maintain complete transparency throughout the process.
Please read and understand the following points carefully:
Nature of Dental Treatment:You understand that dental treatment may involve a range of procedures, including but not limited to dental examinations, X-rays, cleanings, fillings, extractions, crowns, bridges, implants, orthodontic treatments, and other necessary dental procedures. The specific treatment required will be discussed with you by our dental professionals.
Purpose of the Treatment:The purpose of the dental treatment is to maintain and improve your oral health, address any dental issues you may have, and enhance your overall dental well-being.
Risks and Benefits:You acknowledge that there are inherent risks associated with dental treatment, which may include, but are not limited to, bleeding, infection, swelling, pain, allergic reactions, and unexpected outcomes. Our dental team will discuss the potential risks and benefits of the proposed treatment to help you make an informed decision.
Alternatives to Treatment:You have been informed that there may be alternative treatment options available for your dental condition. Our dental professionals will discuss these alternatives with you to help you make an informed decision about your treatment.
Questions and Clarifications:You are encouraged to ask any questions or seek clarifications regarding the proposed treatment, its risks, benefits, and alternatives. Our team will provide you with honest and comprehensive answers to your inquiries.
Consent for Treatment:By signing this consent form, you explicitly consent to the dental treatment as discussed and agreed upon with our dental professionals. You acknowledge that you have had the opportunity to ask questions and have received satisfactory answers.
Right to Withdraw Consent:You have the right to withdraw your consent for treatment at any time before or during the dental procedure. If you choose to withdraw your consent, please inform our dental team immediately.
Confidentiality and Privacy:We are committed to maintaining the confidentiality and privacy of your personal and medical information. Your information will only be shared with relevant dental professionals directly involved in your treatment.
Please take your time to review this consent form thoroughly. If you agree to proceed with the dental treatment, please sign and date this form below.