Forms Library

PSIC does not take a position regarding informed consent, or formally review or endorse any particular documents a practitioner is considering using in their practice. Informed consent is a process. It is the practitioner’s responsibility to know and follow the standards of care and ensure their patient is properly informed about, understands, and consents to treatment. 

Documents containing sample informed consent language are being provided here to help guide the practitioner in creating their own documents which meet the needs of their practice. Rules and laws may differ between states. PSIC believes the practitioner is best served by contacting a health care attorney in their state for advice on the creation of any document they might use in their practice.

For further detail on this position, as well as the elements of a well written consent form, please review our full statement.

Name of Form Type of Form
Statement About Informed Consent for Dentists Form
Apicoectomy Form
Bisphosphonate Drug Therapy Form
Crowns & Bridges Form
General Dentistry Care Form
Implant Surgery & Prosthetics Form
Informed Refusal Form
Nitrous Oxide Sedation Form
Oral Sedation Anesthesia Form
Oral Surgery Extractions Form
Orthodontic Treatment Form
Pediatrics (Children's) Dentistry Form
Periodontal Surgery Form
Root Canal Therapy Form
Sample Dismissal Letter Letter
Americans with Disabilities Act (ADA) Policy
COVID-19 Dental Informed Consent Form
Informed Consent During Public Health Event Form
Pages within Risk Management