Parent/Legal Guardian Consent

Appointments

A parent or legal guardian MUST accompany any child under the age of eighteen to all appointments.  If a parent or legal guardian can not accompany the child a "consent for dental treatment" form must be completed and sent along to the appointment. 

 Parental/Legal Guardian Consent for Dental Treatment:

The “Consent for Dental Treatment” form gives a child’s caregiver, who is not the parent/ legal guardian, permission to consent to dental treatment for your child(ren).

This form must be presented when anyone other than the parent or legal guardian will be accompanying your child(ren) to our practice.

  • All information requested on our authorization form must be completed, or we may be unable to treat your child(ren).
  • Remember to send along this completed form any time your child is being seen by our practice by someone other than the parent or legal guardian.
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Parental/Legal guardian consent Form (PRINT)

 

Since we only care for children, it is not possible for everyone to schedule appointments in the late afternoon or early morning. Children under age 5 are better able to cope with new experiences when well rested. Therefore, we schedule morning appointments for these patients.

We realize that your time is as valuable to you as ours is to us. Our team does everything we can to be ready for you at your scheduled time. On the day of the appointment, allow yourself sufficient time to check in. If you are more than 10 minutes late, we may need to reschedule your child's appointment.

If you will not be able to keep your appointment, please contact us at least 24 hours in advance so that we may give that time to another patient.  Please note: if a family fails 3 appointments in a 2 -year period, we may not schedule subsequent appointments with our practice.

We are aware that school policies make it more difficult for children to be out of school for any reason.  However, dental appointments are EXCUSED ABSCENSES with either a note from the parent or dentist.  We will be happy to provide you with a note if requested.

Regular dental visits are an important part of maintaining your child's oral health. At your child's appointment, you will be given the opportunity to schedule the next preventive visit. Prior to this next preventive visit, you will receive a reminder to verify the day and time. If you have more than one child to schedule, we will do our best to coordinate appointments for your children.


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