I, the undersigned, consent to the examination, diagnostic procedures, and treatment by Dr. Alan S. Lee, DDS, and/or any dental auxiliaries designated by the doctor. I understand that treatment may include but is not limited to: dental examinations, X-rays, cleanings, fillings, extractions, root canals, crowns, bridges, dentures, implants, and other dental procedures as deemed necessary. I understand that I may withdraw my consent at any time by notifying the dental office staff.
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I consent to dental examination, diagnostics, and treatment by Dr. Alan S. Lee, DDS. I have read and understand the consent statement above.
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