Sample treatment authorization for an adult to whom care of a minor has been entrusted
Form for a patient to authorize release of records to another dentist, physician or authorized representative
Updated
Form and recommendations for obtaining consent to disclose patient health information to a third party.
Form for a mutual patient’s physician to confirm medical condition, diagnosis and/or fitness for treatment
Form for capturing a patient’s at-home oral hygiene, dental concerns and treatment history
Updated
Sample letter to inform and educate a patient of necessary X-rays for comprehensive care.
Form to document products that are dispensed to a patient (does not apply to medications)
Form to facilitate patient screening by phone and determine immediacy, appointment need or emergency care
Form for esthetic approval of crowns, veneers or bridges