Consent forms

3RD MOLAR EXTRACTION CONSENT (WISDOM TEETH)

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BIOPSY CONSENT

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BOTOX CONSENT

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CONE-BEAM COMPUTED TOMOGRAPHY (CBCT) CONSENT

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CROWN AND BRIDGE CONSENT

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CROWN LENGTHENING (ESTHETIC) CONSENT

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CROWN LENGTHENING (FUNCTIONAL) CONSENT

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DENTURE (CONVENTIONAL) CONSENT

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DENTURE (IMMEDIATE) CONSENT

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DERMAL FILLER CONSENT

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EXTRACTION CONSENT

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EXTRACTION W/SOCKET PRESERVATION CONSENT (FOR FUTURE IMPLANT)

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FRENECTOMY CONSENT

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GINGIVECTOMY CONSENT

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GINGIVAL GRAFT SURGERY CONSENT

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IMPLANT CONSENT AND POST OPERATIVE FORMS

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IMMEDIATE IMPLANT WITH SINUS LIFT

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INTERNAL BLEACHING CONSENT

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INVISALIGN CONSENT

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SEDATION CONSENT

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OCCLUSAL GUARD CONSENT

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ROOT CANAL (ENDODONTIC THERAPY) CONSENT

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SCALING AND ROOT PLANING CONSENT

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SILVER DIAMINE FLUORIDE (SDF) CONSENT

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SINUS LIFT CONSENT

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SLEEP APPLIANCE (SLEEP APNEA) CONSENT

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SPACE MAINTAINER CONSENT

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WHITENING CONSENT (AT HOME)

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WHITENING CONSENT (IN OFFICE)

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ORAL SEDATION CONSENT

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NITROUS OXIDE CONSENT

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The Leesburg Dentists

706 S. King Street, Suite 102

Leesburg, VA 20175

703-771-8500