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Consent for Endodontic Surgery and Associated Risks Tooth # Anterior Molar 1 Root Bone Replacement Bicuspid One Root Molar 2 Roots Root Amputation Bicuspid Two Roots I hereby authorize DRS. Arousal

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How to fill out consent for endodontic surgery

01

Step 1: Start by reading the consent form thoroughly.

02

Step 2: Make sure you understand all the information provided in the form.

03

Step 3: Fill in your personal details accurately, including your name, address, and contact information.

04

Step 4: Carefully review the risks and benefits section of the form.

05

Step 5: If you have any questions or concerns, consult with your endodontic surgeon before proceeding.

06

Step 6: Sign and date the form to indicate your consent.

07

Step 7: Keep a copy of the signed consent form for your records.

08

Step 8: Return the completed form to the endodontic surgeon or their staff.

Who needs consent for endodontic surgery?

01

Anyone who requires endodontic surgery needs to give their consent.

02

This includes individuals who have been diagnosed with dental pulp infections, root canal complications, or other endodontic conditions that warrant surgical treatment.

03

Consent is necessary for both adult patients and parents or legal guardians of minor patients.

04

It is crucial to obtain consent to ensure that the patient is fully aware of the procedure, risks involved, and provides voluntary permission for the surgery to be performed.

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