Patient Information Update Forms

I authorize the dental professionals at Pecan Tree Family Dentistry to perform any necessary x-rays, study models, photographs, or other diagnostic tests required to assess my (or my dependent’s) dental condition. I understand that these diagnostic tools are essential for an accurate diagnosis and treatment planning.

Upon completion of this assessment, I give consent for Pecan Tree Family Dentistry to proceed with any recommended treatments that have been mutually agreed upon, and to utilize additional assistance as necessary to ensure proper care. I understand that the recommended treatments will be explained to me, including their purpose, benefits, and any associated risks or alternatives.

I acknowledge and accept the general risks associated with dental procedures, including but not limited to infection, discomfort, and unexpected outcomes. I understand that while the dental professionals at Pecan Tree Family Dentistry strive to provide the highest standard of care, no guarantees can be made regarding the success or outcome of the treatment.

I understand that I have the right to ask questions and seek clarification about any aspect of my treatment plan. I also have the right to refuse any treatment or procedure, understanding that this may impact my oral health.

I certify that I have read and understood the information provided in this consent form. I consent to the use of my personal information for the purposes outlined above, and I agree to be bound by the terms and conditions set forth herein.