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DENTAL PROGRAMS CONSENT FOR ENDODONTIC (ROOT CANAL) SERVICESPatient Name Date of Birth I hereby authorize Dr., and any other dentists of to perform an endodontic (root canal) procedure on tooth (teeth)
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Consent for endodontic root is a form that allows the patient to authorize the endodontist to perform root canal treatment.
The patient who will undergo the endodontic root procedure is required to fill out and file the consent form.
The patient must carefully read the information on the consent form and sign it to indicate their approval for the endodontic root treatment.
The purpose of consent for endodontic root is to ensure that the patient understands the risks and benefits of the procedure and agrees to undergo the treatment.
The consent form must include details about the procedure, risks, benefits, alternatives, and any other relevant information regarding the endodontic root treatment.
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