Resource Library
Consent Forms
General Dental Treatment Consent
A structured general consent form for examination, radiographs if appropriate, preventive care, restorative care, risks, alternatives, and patient questions.
Best used for
Where this helps inside the clinic.
New patients
Routine care
Treatment planning
Resource structure
What the resource should help your team capture.
Treatment Scope
Explain the general categories of care the patient may receive.
Examination
Radiographs if indicated
Preventive care
Restorative care
Local anesthesia if needed
Referrals if needed
Risks and Alternatives
Create space for discussion and patient questions.
Risks discussed
Alternatives discussed
No-treatment option discussed
Patient questions answered
Financial Responsibility
Clarify that consent is separate from insurance approval.
Estimated fees explained
Insurance limitations explained
Patient responsibility acknowledged
Signatures
Document consent and witness if required.
Patient or guardian name
Signature
Date
Provider
Witness if required
The Practice Presence for Dental Clinics
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