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Oral Surgery Consent Form

Oral Surgery Consent Form


An oral surgery consent form is required by mostly children and adult patients. This form is required when oral surgical incisions or procedures need to be implemented. Some of the most common oral surgical procedures that require this consent form to be filled include removal of impacted molars or dental implants, jaw related problems and dentures, cleft palate repair etc. This form provides information on the different types of oral surgeries that a patient might need to undergo. A dental patient has to provide their consent to their doctors or clinic before any oral surgery can commence.

Oral Surgery Consent Form

Oral Surgery Consent Form

Oral Surgery Consent Form

You can Download the Oral Surgery Consent Form Template, customize it according to your needs, and Print it.Oral Surgery Consent Form Template is either in MS Word or Editable PDF.

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Patient Information:

The template collects essential patient information such as name, address, contact details, age, sex, marital status, and dental insurance details.

Medical History:

It includes sections to document the patient’s dental and medical history, including previous oral surgeries, treatments, and current oral health conditions.

Emergency Contact:

The template allows for specifying an emergency contact person in case of unforeseen circumstances.

Consent to Treatment:

The template typically includes a section where the patient or their legal guardian consents to the proposed oral surgery procedure.

Explanation of Risks:

There might be a section where the surgeon explains the potential risks, benefits, and alternatives to the proposed procedure.


Standardized Format:

Using a template ensures that all necessary information is collected consistently, improving efficiency and reducing errors.

Legal Protection:

A signed consent form can help protect the surgeon and the clinic in case of potential complications or disputes.

Clear Communication:

The template facilitates clear communication between the patient and the surgeon about the proposed procedure, including risks and benefits.

Patient Safety:

By documenting the patient’s medical history, the surgeon can also better assess the patient’s suitability for the procedure and take necessary precautions.


The template can help ensure compliance with legal and also ethical standards for informed consent.

Important Disclaimer: These templates are for informational purposes only. They are not a substitute for legal advice. Before using any template, consult with an attorney to ensure it meets your specific needs. EditableForms.com is not a law firm and cannot accept legal requests.