To submit the Tooth Gem Consent Form, please ensure all fields are filled out completely. You can hand deliver the signed form to our office or fax it to our provided number. For electronic submissions, email the completed form to the designated email address listed on our website.

Important dates for submitting the Tooth Gem Consent Form include consultation appointments or specific event dates in 2024 and 2025. Ensure to submit this form at least one week prior to your scheduled appointment to allow for processing. It is essential to keep track of these dates for timely submissions.

The primary purpose of this Tooth Gem Consent Form is to obtain informed consent from clients wishing to have tooth jewels applied. It also serves to document any allergies or sensitivities that may influence the procedure. In addition, it clarifies the responsibilities of both the client and the service provider during the application process.

• 1. Allergy Information: Questions about allergies to dental materials.
• 2. Tooth Condition: Indicates whether the desired tooth is real.
• 3. Sensitivity Status: Confirms if the client has sensitive teeth.
• 4. Consent Authorization: Client authorization for the procedure.
• 5. Tooth Jewel Selection: Options for selecting the exact tooth for placement.

Failing to submit the form may delay your tooth jewel application. Important consent and allergy information will not be recorded. This may result in unsatisfactory service or complications during the procedure.

• Incomplete Client Information: Missing data can lead to invalid consent.
• Allergy Risks: Without allergy disclosures, adverse reactions may occur.
• Service Delays: Delays in service if consent is not received on time.

• 1. Initial Consultation: Use when planning to discuss tooth jewel applications.
• 2. Pre-application Requirement: Mandatory form completion before procedure.
• 3. Dental Visits: When visiting professionals offering tooth jewels.