About 8 min
CID-IMP-01
Dental Implant Placement Consent
Informed consent for placement of one or more endosseous dental implants.
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Patient and Consent Forms You Can Complete and Sign Online
Read it at home, ask your questions, sign only when you're ready
Schedule ConsultationPatient Resources · 54 Documents
Consent Is A Conversation. This Is Just The Part You Can Do In Your Own Time.
Nobody makes a good decision about surgery while holding a clipboard in a waiting room, five minutes before it starts. So every form we use is here, in full, at a permanent link you can open on your phone at your kitchen table — read it twice, look up a word, write down the questions you want answered before you agree to anything.
Each one walks the same path: what's being proposed, what it should do for you, the risks that genuinely matter, the alternatives including doing nothing at all, and what we need from you afterward. Fill it in, sign with your finger or your keyboard, and download a properly named PDF for your own records.
What we will never do is treat a signature as the end of the conversation. Your treating dentist still owes you the discussion — the version specific to your mouth, your health history, and your scan. Bring every unanswered question to it.
The Practice
This Practice, At A Glance
Forms are completed entirely in your browser. Download the signed PDF and bring it with you to your appointment — never send health details through social media or an ordinary contact form.
The full library
Find Your Form
Your clinical team will tell you which of these you need. If you are not sure, call the office at (510) 574-0496 before you sign anything — and never sign a consent form after taking sedating medication.
Search in plain English — you don’t need the clinical name.
Implant surgery
15 formsAbout 7 min
CID-IMP-02
Extraction With Immediate Implant Consent
Consent for removing a tooth and placing an implant in the fresh extraction site.
Open & signAbout 10 min
CID-IMP-03
Full-Arch Implant Surgery Consent (All-on-4, All-on-6, All-on-8)
Informed consent for full-arch implant treatment, including any immediate-load fixed provisional teeth placed the same day.
Open & signAbout 10 min
CID-IMP-04
Zygomatic Implant Surgery Consent
Informed consent for zygomatic implants anchored in the cheekbone for severe upper-jaw bone loss.
Open & signAbout 8 min
CID-IMP-05
Failed Implant Removal and Revision Consent
Informed consent for removing a failing or failed dental implant and, where possible, rebuilding the site.
Open & signAbout 8 min
CID-IMP-06
Bone Grafting Consent
Consent for ridge preservation or augmentation using graft material and possible membrane.
Open & signAbout 8 min
CID-IMP-07
Sinus Lift and Bone Graft Consent
Consent for elevation of the maxillary sinus membrane and grafting, with or without implant placement.
Open & signAbout 8 min
CID-IMP-08
Block Bone Graft Consent
Consent for augmentation using a block of bone from the patient or donor source.
Open & signAbout 6 min
CID-IMP-09
Peri-Implantitis Non-Surgical Treatment Consent
Consent for cleaning and decontaminating an infected implant without opening the gum.
Open & signAbout 8 min
CID-IMP-10
Peri-Implantitis Surgical Treatment Consent
Consent for opening the gum to decontaminate an infected implant, with or without grafting.
Open & signAbout 9 min
CID-IMP-11
Inferior Alveolar Nerve Lateralization Consent
Consent for moving the lower jaw nerve aside to place implants in a severely resorbed jaw.
Open & signAbout 6 min
CID-IMP-12
Platelet-Rich Fibrin (PRF) Consent
Consent for drawing a small amount of your own blood to make a healing membrane used during surgery.
Open & signAbout 7 min
CID-IMP-13
Treatment Plan Change During Surgery Authorization
Sets out, in advance, what your surgeon may and may not change once surgery has begun.
Open & signAbout 6 min
CID-IMP-14
Temporary Full-Arch Teeth Acknowledgment
What to expect from the temporary set of teeth worn while your implants heal.
Open & signAbout 7 min
CID-IMP-15
Implant-Retained Overdenture Consent
Consent for a removable denture that clips onto implants — how it differs from fixed teeth.
Open & sign
Oral surgery
14 formsAbout 7 min
CID-ORS-01
Dental Extraction Consent
Consent for simple or surgical removal of one or more teeth.
Open & signAbout 7 min
CID-ORS-02
Gingival (Gum) Graft Consent
Consent for soft-tissue grafting to increase gum thickness, coverage, or attached tissue.
Open & signAbout 7 min
CID-ORS-03
Guided Tissue Regeneration Consent
Consent for periodontal or peri-implant regenerative treatment using grafts and membranes.
Open & signAbout 7 min
CID-ORS-04
Oral Biopsy Consent
Consent to remove all or part of an oral lesion for laboratory examination.
Open & signAbout 6 min
CID-ORS-05
Frenectomy Consent
Consent for release or removal of a restrictive oral frenum.
Open & signAbout 6 min
CID-ORS-06
Laser Dental Procedure Consent
Consent for use of a dental laser during soft- or hard-tissue treatment.
Open & signAbout 8 min
CID-ORS-07
LANAP Periodontal Procedure Consent
Consent for laser-assisted periodontal treatment using the LANAP protocol.
Open & signAbout 9 min
CID-ORS-08
Antiresorptive Medication and Jaw Risk Consent
Consent for invasive dental treatment when antiresorptive or antiangiogenic medication may affect jaw healing.
Open & signAbout 8 min
CID-ORS-09
Impacted and Wisdom Tooth Removal Consent
Consent for surgical removal of a wisdom tooth or other tooth buried in bone or gum.
Open & signAbout 8 min
CID-ORS-10
Coronectomy Consent
Consent for removing the crown of a wisdom tooth and deliberately leaving the roots to protect the nerve.
Open & signAbout 6 min
CID-ORS-11
Alveoloplasty and Ridge Recontouring Consent
Consent for smoothing and reshaping the jaw ridge so a denture or implant bridge can seat properly.
Open & signAbout 7 min
CID-ORS-12
Sinus Opening (Oroantral) Closure Consent
Consent for surgically closing an opening between the mouth and the sinus.
Open & signAbout 7 min
CID-ORS-13
Surgical Debridement and Infection Treatment Consent
Consent for opening, draining, and cleaning an infected area of the mouth or jaw.
Open & signAbout 7 min
CID-ORS-14
Crown Lengthening Consent
Consent for reshaping gum and bone to expose more of a tooth before it is restored.
Open & sign
Sedation & imaging
4 formsAbout 9 min
CID-SED-01
Intravenous Sedation Consent
Consent for intravenous moderate sedation administered during dental treatment.
Open & signAbout 7 min
CID-SED-02
Oral and Nitrous Oxide Sedation Consent
Consent for minimal sedation using nitrous oxide, an oral sedative medication, or both.
Open & signAbout 5 min
CID-SED-03
3D CBCT Scan Consent
Consent for cone-beam computed tomography used in diagnosis and treatment planning.
Open & signAbout 5 min
CID-SED-04
Sedation Escort and Discharge Acknowledgment
Confirms who is taking you home after sedation and what you must not do afterward.
Open & sign
Restorative & maintenance
7 formsAbout 8 min
CID-RST-01
Implant Crown and Fixed Hybrid Restoration Consent
Consent for implant-supported crowns, bridges, overdentures, or fixed full-arch restorations.
Open & signAbout 5 min
CID-RST-02
Implant Care and Maintenance Acknowledgment
Acknowledgment of daily hygiene, professional maintenance, and follow-up responsibilities.
Open & signAbout 6 min
CID-RST-03
Teeth Whitening Consent
Consent for in-office or take-home dental bleaching.
Open & signAbout 5 min
CID-RST-04
Dental Cleaning Consent
Consent for routine dental prophylaxis when current findings support that service.
Open & signAbout 7 min
CID-RST-05
Scaling and Root Planing (Deep Cleaning) Consent
Consent for deep cleaning below the gum line to treat periodontal disease.
Open & signAbout 5 min
CID-RST-06
Night Guard and Occlusal Guard Consent
Consent for a custom guard worn to protect teeth, implants, or restorations from grinding.
Open & signAbout 5 min
CID-RST-07
Bite Adjustment Consent
Consent for reshaping biting surfaces to balance how the teeth meet.
Open & sign
Patient information
14 formsAbout 5 min
CID-ADM-01
Recommended Examination or Imaging Refusal
Documents informed refusal of an examination, X-ray, scan, or other recommended diagnostic service.
Open & signAbout 4 min
CID-ADM-02
Dental Materials Fact Sheet Acknowledgment (California)
California requires dentists to give patients the Dental Board's dental materials fact sheet and to keep a signed acknowledgment of receipt.
Open & signAbout 4 min
CID-ADM-03
Notice of Privacy Practices Acknowledgment
Acknowledges receipt of the practice’s Notice of Privacy Practices.
Open & signAbout 6 min
CID-ADM-04
Photography and Media Release
Optional permission to use your clinical photographs, video, or testimonial outside your dental record. Declining changes nothing about your care.
Open & signAbout 6 min
CID-ADM-05
Dental Records Release Authorization
Authorizes release of specified dental records to a named person or organization.
Open & signAbout 12 min
CID-ADM-06
Confidential Health History
Medical and dental history used to plan safe implant, surgical, restorative, and sedation care.
Open & signAbout 8 min
CID-ADM-07
New Patient Registration
Contact, emergency, insurance, communication, and responsible-party details for new patients.
Open & signAbout 6 min
CID-ADM-08
AI Smile Simulation Photo Authorization
Authorizes the practice to send your facial photograph to Google and OpenAI to generate an AI smile simulation.
Open & signAbout 6 min
CID-ADM-09
Recommended Treatment Refusal
Documents informed refusal of a recommended treatment, not merely an examination or scan.
Open & signAbout 4 min
CID-ADM-10
Interpreter Services Offer and Response
Records that a free interpreter was offered, and whether you accepted or declined one.
Open & signAbout 5 min
CID-ADM-11
Who We May Talk To About Your Care
Names the people we may discuss your treatment with, and how you want to be contacted.
Open & signAbout 6 min
CID-ADM-12
Medical Clearance and Physician Coordination Authorization
Lets us contact your doctor about your health before surgery, and explains why we may need to.
Open & signAbout 5 min
CID-ADM-13
Post-Operative Instructions Acknowledgment
Confirms you received your after-surgery instructions and know when to call.
Open & signAbout 5 min
CID-ADM-14
Antibiotic Premedication Acknowledgment
For patients advised to take an antibiotic before dental treatment, and why it matters.
Open & sign
Your signed form goes into your dental record
That is the point of signing it: once it reaches us it is filed with your chart and protected like every other medical record we hold. Download the signed PDF saves the finished form to your device — bring it to your appointment, or hand it to the front desk, and we will file it from there. The website is only where you fill it in: it keeps no copy of your answers either way, which is also why you should never send health details through an ordinary contact form or a social media message.