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Supplemental Orthodontic Treatment Consent Form COVID-19 Pandemic Thank you for your continued trust in our practice. As with the transmission of any communicable disease like a cold or the flu, you
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How to fill out supplemental orthodontic treatment consent
How to fill out supplemental orthodontic treatment consent
01
Obtain the supplemental orthodontic treatment consent form from the orthodontist or orthodontic office.
02
Read through the form carefully to understand the information and requirements.
03
Fill out the patient information section, including the full name, address, and contact details of the patient receiving the treatment.
04
Provide the name and contact information of the parent or legal guardian if the patient is a minor.
05
Specify the orthodontic treatment being consented to and any additional details or instructions provided by the orthodontist.
06
Review and acknowledge the risks, benefits, and alternative treatment options mentioned in the form.
07
Sign and date the consent form to indicate your agreement and understanding of the treatment and its associated risks.
08
Return the completed consent form to the orthodontist or orthodontic office as instructed.
Who needs supplemental orthodontic treatment consent?
01
Supplemental orthodontic treatment consent is needed for individuals who are undergoing orthodontic treatment or planning to undergo such treatment. This includes both adults and children who require braces, retainers, aligners, or other corrective appliances to address dental misalignment or jaw-related issues. The consent ensures that the patient or their legal guardian understands the nature of the treatment, its potential risks, benefits, and alternative options, and gives their voluntary agreement to proceed with the recommended orthodontic interventions.
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What is supplemental orthodontic treatment consent?
Supplemental orthodontic treatment consent is a form that allows a patient to give permission for additional orthodontic procedures beyond the initial treatment plan.
Who is required to file supplemental orthodontic treatment consent?
Both the patient receiving orthodontic treatment and their legal guardian (if the patient is a minor) are required to file supplemental orthodontic treatment consent.
How to fill out supplemental orthodontic treatment consent?
Patients or legal guardians can fill out supplemental orthodontic treatment consent by completing the necessary information on the form provided by the orthodontist and signing it.
What is the purpose of supplemental orthodontic treatment consent?
The purpose of supplemental orthodontic treatment consent is to ensure the patient fully understands and agrees to any additional orthodontic procedures that may be recommended by the orthodontist.
What information must be reported on supplemental orthodontic treatment consent?
Supplemental orthodontic treatment consent must include details of the additional procedures being recommended, potential risks and benefits, and the patient's consent to proceed.
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