To submit this form, please ensure all necessary fields are filled, and all required signatures are provided. Submit the completed consent form via one of the following methods: Email: consent@thrivedental.com, Fax: (123) 456-7890, or In-person: Thrive Dental & Orthodontics, 123 Smile Lane, Dentaltown, TX 12345. For any questions or further instructions, contact our office at (123) 456-7890. Our advice is to double-check the form for completeness and clarity before submission to prevent any delays in your scheduled procedure.

No specific important dates are applicable for this form in 2024 and 2025.

The purpose of this consent form is to ensure that patients undergoing alveoloplasty at Thrive Dental & Orthodontics are fully informed about the procedure and its associated risks. By completing and signing this form, patients acknowledge their understanding and agreement to the treatment plan proposed by their dentist. This document also serves to protect both the patient and the dental practice by clearly outlining expectations and responsibilities. Alveoloplasty is a surgical procedure intending to smooth and reshape the jawbone to prepare it for future dental restorations like dentures. The form provides vital information about potential complications and postoperative care instructions. Understanding these elements is essential for a successful procedure. The patient's signature on the form indicates they have received complete information about the procedure, have had all their questions answered, and agree to proceed with the treatment. Both patient and healthcare provider must retain copies of the signed consent form to document agreement and understanding.

• 1. Patient's Name: Enter the full name of the patient undergoing the procedure.
• 2. Signature of Patient, Legal Guardian, or Authorized Representative: The patient, their legal guardian, or an authorized representative must sign here to give consent.
• 3. Witness' Signature: A witness must sign to confirm that the patient has provided their consent.
• 4. Date: Enter the date when the form is signed.

Failing to submit this consent form may result in the postponement or cancellation of the alveoloplasty procedure.

• Procedure Delay: Without consent, the dental practice cannot proceed with the treatment, causing delays.
• Informed Consent: Lack of a properly signed consent form means the patient has not formally agreed to the risks and treatment plan.

• 1. Pre-surgical Consent: Prior to undergoing alveoloplasty, the patient must provide informed consent.
• 2. Discussing Risks: When discussing potential risks and benefits of the procedure with the patient.
• 3. Legal Documentation: To legally document the patient's agreement to the procedure and associated risks.