BIOPSY Consent Form

I, name , consent to having a biopsy performed Performed by either Dr. Farzin Ghannad, Dr. Hannu Larjava, Dr. Nabil Nadji, Dr. Robert Straga, or Dr. Farzan Ghannad. This procedure may involve the use of local anesthetic and dissolvable sutures. A post-operative visit may be required 1-3 weeks later.
Signature of Patient (parent or legal guardian)

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