Get the free Refusal of Dental Treatment Form - North Bethesda Periodontal Group

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NORTH BETHESDA KHALID CHAUDHARY, DDS, MS PERIODONTAL GROUP JOAN HUMANITY, DDS MS DIPLOMATS AMERICAN BOARD OF PERIODONTOLOGY Refusal of Dental Treatment Form Patient Name: Date: Risks of Not Having

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What is refusal of dental treatment?

Refusal of dental treatment is when a patient declines to receive or continue with recommended dental care.

Who is required to file refusal of dental treatment?

Dental providers are required to document and file refusal of dental treatment forms when a patient declines care.

How to fill out refusal of dental treatment?

Refusal of dental treatment forms typically require basic patient information, reason for refusal, and signatures from both the patient and the provider.

What is the purpose of refusal of dental treatment?

The purpose of refusal of dental treatment is to ensure that the patient has been informed of the risks and consequences of declining necessary dental care.

What information must be reported on refusal of dental treatment?

Information such as patient name, date of refusal, reason for refusal, and signatures must be reported on refusal of dental treatment forms.

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