NOVACHEM
DENTAL CLINIC
Patient Forms
Consent Forms
Fill in on your phone, tablet, or the front-desk computer — then print. Or print blank and complete by hand.
Fill in on your phone, tablet, or the front-desk computer — then print. Or print blank and complete by hand.
How to use these: open the form that matches the treatment, type directly into the fields (name, age, contact, etc.), then use your browser's Print (Ctrl/Cmd + P) to print or save as PDF. Every form fits on a single A4 page.
Procedure checklist for routine treatments — extraction, scaling, filling, dressing, polishing, fluoride, crowns, root canal, denture, braces.
Cosmetic whitening treatment — benefits, sensitivity risks, and realistic-results consent.
Plaque and tartar removal — routine cleaning consent with gum-health risks explained.
Removal of a damaged or impacted tooth — full risk and aftercare consent.
Endodontic therapy to save an infected tooth — procedure and risk consent.