Printable Teeth Whitening Consent Form Whitening Consent Form Baylee Dental 16850 S Hwy 441 Ste 301 Summerfield FL 34491 352 307 3006 Whitening Consent Form I understand that my professional whitening treatment cannot be guaranteed as teeth whiten differently for each individual depending on his or her genetic traits and types of stains
Teeth Whitening Consent Form is a document signed by the patient before conducting a tooth whitening procedure A document signed by the patient before any medical treatment or medical procedure is called a consent form Accounting Templates Art Media Budget Templates Business Templates Calendar Templates Certificates Charts Education Templates INTRODUCTION This information has been given with the intention that you can make an informed decision about having your teeth whitened using the Boutique Whitening system There is no time limit by which you must make a decision to have this treatment done and sign and return this form
Printable Teeth Whitening Consent Form
Printable Teeth Whitening Consent Form
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Teeth Whitening Consent Form Template
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LED Teeth Whitening Informed Consent Form To the CLIENT You have a right to be informed about your condition and its treatment so that you may decide whether or not to undergo the procedure after knowing the risks and hazards involved INSTRUCTIONS Avoid smoking during treatment and reduce staining foods such as tea coffee red wine etc Brush your teeth before and after bleaching Brush the trays with your normal toothbrush and tooth paste Apply no more than 1 3 to 1 2 of syringe gel per tray and wear for 30 minutes per day
An informed decision about having my teeth whitened I may take as much time as I wish to make my decision about signing this informed consent form I have the right to ask questions about any procedure before agreeing to undergo the procedure My dentist has informed me that my teeth are discolored and could be treated by in office At Home Teeth Whitening Information Informed Consent General Information Teeth Whitening is designed to lighten the color of your teeth When done properly the whitening will not harm your teeth or gums Significant lightening can be achieved in the vast majority of cases but the results cannot be guaranteed
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Teeth Whitening Consent Form Template Printable In PDF Word
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Tooth Whitening Informational Consent Form General Information Tooth whitening is designed to lighten the color of your teeth Significant whitening can be achieved in the vast majority of cases but the results cannot be guaranteed When done properly the whitening will not harm your teeth or gums Teeth Whitening Information and Consent Form This template download comes as a PDF file text boxes graphics and words cannot be moved or edited Please request customization prior to purchasing if you would like changes made These files can be printed at home on your computer or at a local print shop
Boost in office tooth whitening is a procedure designed to lighten the color of my teeth using a hydrogen peroxide gel During the procedure the whitening gel will be applied to my teeth in a series of sessions each lasting 20 minutes Maximum number of sessions in one visit is 3 Procedure Venus Chairside professional tooth whitening is a procedure designed to lighten the color of your teeth using a hydrogen peroxide mixture It produces maximum whitening results in the shortest possible time with minimum sensitivity During the procedure the whitening gel will be applied to your teeth for three 3 15 minute sessions
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Whitening Consent Form Baylee Dental 16850 S Hwy 441 Ste 301 Summerfield FL 34491 352 307 3006 Whitening Consent Form I understand that my professional whitening treatment cannot be guaranteed as teeth whiten differently for each individual depending on his or her genetic traits and types of stains
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Teeth Whitening Consent Form is a document signed by the patient before conducting a tooth whitening procedure A document signed by the patient before any medical treatment or medical procedure is called a consent form Accounting Templates Art Media Budget Templates Business Templates Calendar Templates Certificates Charts Education Templates
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Printable Teeth Whitening Consent Form - Exact results are not guaranteed Teeth with multiple colourations bands or spots due to tetracycline staining or fluorosis do not whiten as well and may appear more spotted after treatment These may require further treatment to achieve a uniform result in the form of veneers
