Root Canal Treatment Consent Form

ENDODONTIC (ROOT CANAL) TREATMENT CONSENT

Please read and consent to all the information below and feel free to ask any questions you may have.
Treatment Awareness(Required)
Guarantee(Required)
Treatment Success(Required)
Associated Risks(Required)
Procedural Errors(Required)
Fracture Risk(Required)
Post Op Visits(Required)
Decay(Required)
Endodontic Consent(Required)
Please ask the office staff for more details
DD slash MM slash YYYY
Name(Required)

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