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Dental Consent Form
With dental procedures, there can be issues that arise during the procedure that also need to be addressed. The most common issue is loose and diseased teeth. These teeth can cause a myriad of health issues for your pet including:
Extremely sore and painful teeth
Septicemia with potential for organ involvement
Endocarditis (infection of the heart valves)
Halitosis (putrid smelling breath)
Gum and bone resorption with exposure
Tooth root abscesses
Numerous oral/throat inflammation issues
Any tooth that is loose and diseased needs to be extracted!!! If teeth are extracted, the animal will be placed on antibiotics and pain medication (price varies with size of animal; can give estimate upon request) and a $7.50 per tooth extraction fee applies also. Please read and initial your requests below:
I authorize any necessary tooth extractions
Initials
I would like the doctor/dental technician to call me prior to extracting any teeth. If I am not available by phone, then:
Extract teeth at the doctor's discretion
Do NOT extract any teeth
Phone number to reach me
Initials
I do NOT authorize any extractions
Initials
Pet(s) Name(s)
Owner Signature
Date
MM
DD
YYYY
New Clients
What To Expect
Take A Tour
Make an Appointment
New Client Registration Form
About Us
Our History
Location & Hours
Our Team
Pet Services
Alternative and Complementary Therapy
Anesthesia and Patient Monitoring
Medical Services
Nutritional Counseling
Preventive Services
Surgical Services
Wellness and Vaccination Programs
Additional Services
Advanced Treatments
Pet Health
Pet Health Library
Pet Health Checker
Pet Insurance
Pet Food Recalls
Product Recalls
How-To Videos
News
Online Pharmacy