I understand that all the above information I have given is correct and accurate, that it will be held in the strictest of confidence and it is my responsibility to inform this office of any change in my child’s medical status. I consent to the performing of dental procedures agreed to be necessary and advisable for my child.
I also consent that my child’s radiographs, dental and facial photographs, dental scans and dental models be kept in our files and be used for treatment planning and follow-up, patient/parents’ education and medical/dental lectures.
