I authorize and give consent to Dr. Cho and her staff to perform dental treatment, including but not limited to, local anesthesia, analgesia and other such treatment which may be necessary for the above named patient. I understand that my photos may be used for teaching or sharing purposes. I also understand that the use of these agents and some procedures embody a certain risk. I certify that I have read and understand the above information to the best of my knowledge. The above questions have been accurately answered. I understand that there is a charge for missed or broken appointments without 48 Hour notice.