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Dental Consent Form

Pet's Name:

Dental Radiology

Dental radiographs are taken if disease is present to determine the extent of the damage to the structure of the tooth and root in order to evaluate whether or not the tooth can be salvaged or if it needs to be removed. This allows the veterinarian to make the best decision for your pet and will result in an additional fee for the imaging.

Extractions Are Only Performed If Absolutely Necessary!

I acknowledge that at the veterinarian’s discretion, any teeth that are so affected by severe dental disease that they cannot otherwise be salvaged will be removed/extracted by the veterinarian for the health and comfort of your pet. Costs for extractions vary depending on the quantity of extractions, location of the teeth to be extracted, and severity of damage to the surrounding tissue.
By signing this form, I defer to the veterinarian and understand they will use their best judgment and practice in determining the necessity for extractions and radiographs. I acknowledge that they and their team will not call me prior to every extraction due to the time constraints involved in such a procedure. Please type your full name below as signature of acknowledgment of the above statement.*

Full Name:
Today's Date:

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