Minor Consent Form

INFORMATION ON PROCEDURES AND INFORMED CONSENT FOR MINOR

We are committed to providing the highest quality dentistry which will assist our patients in achieving excellent dental health. Because we believe in our patients being well educated and well informed about their dental care, an explanation of procedures should include a discussion of the possible complications. This form lists most of the possible complications that can occur with dental treatment, and we welcome your discussion and any questions about any aspect of your dental care. All minors coming to their appointments without a parent or legal guardian must bring this signed form, otherwise we will not be able to see them for their visit. Please print the form below, fill out the necessary portions, sign, and send with minor patient to their scheduled appointment.

Printable Minor Consent Form (461 downloads )