Get Informed Consent Tooth Removal (extraction) - Burchfield, Dds

Filling out the Informed Consent Tooth Removal form is an essential step before undergoing dental extraction. This guide provides clear, step-by-step instructions to help you effectively complete the form online.

Follow the steps to successfully fill out your consent form.

1. Click 'Get Form' button to obtain the document and open it in your preferred online editor.
2. Fill in your name in the designated 'Patient Name' field. Ensure accuracy in spelling as this information is important for your records.
3. Enter the date on which you are completing the form in the 'Date' field.
4. Specify the tooth number that is to be extracted in the 'Tooth #' section. If unsure, consult your dental provider.
5. Read through the explained benefits and risks of tooth removal as outlined in the document. Take note of any potential complications and make sure all your questions have been answered.
6. Acknowledge your understanding of the treatment recommendations by Dr. Burchfield or Dr. Melton by checking the appropriate boxes or noting your agreement as directed.
7. Review the risks associated with avoiding the procedure, ensuring you are aware of issues such as infection or pain.
8. Sign and date the form at the bottom to indicate your consent. Be sure this is your signature as it confirms your agreement to the treatment.
9. If required, have a witness sign the form, noting their name and the date of signing as well.
10. Once all fields are completed, save your changes. You can download, print, or share the form as needed.

Complete your informed consent form online today to ensure a smooth dental experience.