Professional Protector Plan Dental Forms

• After-hours Patient Contact Form
• Informed Consent: Discussion and Consent
• Discussion and Consent for Fixed Bridge Restorations
• Discussion and Consent for Crown Restorations
• Discussion and Consent for Implant Placement Surgery
• Discussion and Consent for Implant Restoration
• Discussion and Consent for Extraction
• Discussion and Consent for Root Canal Treatment
• Discussion and Consent for Periodontal (Gum) Treatment
• Discussion and Refusal of Periodontal (Gum) Treatment
• Discussion and Consent for Use of Protective Stabilization
• Informed Refusal: Discussion and Refusal of Treatment
• Authorization to Release Confidential Patient Information
• Authorization to Transfer or Forward Dental Records
• Patient Needle Stick Reimbursement Form
• Patient Referral Letter Template
• Refund/Fee Waiver Release
• Release of All Claims
• Sample Patient Termination Letters