Consent Forms 
 

The various letter/form templates have been provided by
Dr. James Broadbent, Orthodontist
as presented in his DVD program entitled

Achieving Excellence in Functional Jaw Orthopedics
 and Case Finishing


Ø New Orthopedic/Orthodontic Patient Letter

Ø Progress Report

Ø Consent to undergo
orthopedic/orthodontic treatment

Ø Agreement to continue general dental supervision throughout orthopedic/orthodontic
and TMJ treatment

Ø Authorization Medical/Dental Information

Ø MEDIATION/ARBITRATION AGREEMENT

Ø CONSENT FORM FOR AIR-ROTOR STRIPPING (ARS)

Link to Microsoft Word Templates

  The documents/forms are samples for your alteration and review by your legal council
prior to implementation in your general dental practice.
E&OE 2011

69 Beckwith Street, North
Smiths Falls, Ontario, K7A 2B6
Tel: 613-283-6841   Fax: 613-283-5386
lab@orthodontic.ca
1-800-267-7982