Get the CONSENT FOR FREE DENTAL EXAMINATION BY DENTIST
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Facility Name: CONSENT FOR FREE DENTAL EXAMINATION BY DENTIST Please Complete Information & Return Form via Fax or by Mail The undersigned authorizes Sprinter Dental Services to perform the free dental
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How to fill out consent for dental examination
How to fill out consent for dental examination:
01
Ensure that all personal information is correctly and accurately filled out on the consent form, including your full name, date of birth, and contact information.
02
Read through the entire form carefully, paying close attention to any terms or conditions mentioned. If there are any sections or clauses that you don't understand, don't hesitate to ask your dentist or dental staff for clarification.
03
Sign and date the consent form at the designated spaces. Your signature confirms that you understand and agree to undergo the dental examination and any associated treatments or procedures.
04
If you are filling out the consent form on behalf of a minor or a dependent, make sure to include their information and sign the form as the legal guardian or parent.
05
Attach any additional required documents or medical history information that may be applicable to your dental examination.
06
Retain a copy of the completed and signed consent form for your records. It's always a good idea to have a copy handy in case any questions or issues arise in the future.
Who needs consent for dental examination:
01
Adults: Any adult patient who is of legal age (usually 18 years or older) must provide consent for their dental examination. This consent is necessary to ensure that the patient understands the potential risks, benefits, and alternatives to the recommended dental procedures.
02
Minors: For children or individuals who are not of legal age, parental or guardian consent is required. The person responsible for the child or dependent's well-being must sign the consent form on their behalf.
03
Mentally incapacitated individuals: If a patient is deemed mentally incapable of providing informed consent, legal guardians or individuals with power of attorney may be required to provide consent for their dental examination and any necessary treatment. This ensures that the patient's best interests are considered.
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