Informed Consent For Dental Procedure
Dr. Azouz has thoroughly discussed and I understand the above procedure. I have been told of the treatment alternatives including having no treatment at all. I have further been advised of the risks and possible consequences of the above procedure. I have freely elected to proceed with the procedure and I am willing to take such risks. Further, I will hold Dr. Azouz harmless for complications, risks, or consequences arising from this procedure.