Consent for Dental Prophy

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Consent Form for Dental Prophy

Please use the form below, and we’ll get back to you as quickly as possible. If you need immediate assistance, please call us directly during business hours at 509-462-7387.

Your pet has been scheduled for a dental procedure to treat/prevent periodontal disease. We believe that a complete dental health program can significantly improve the comfort and length of any pet's life. A general anesthetic is required to perform these procedures.

After your pet is anesthetized, we will clean your pet’s teeth with ultrasonic and hand scaling instruments, then polish. We will then examine the teeth and gum tissue using a dental probe. This will determine if further treatment is indicated.

Extraction (pulling) of diseased teeth may be necessary if there is a loss of normal attachment to the bone due to advanced periodontal disease.

I understand my pet will be under anesthesia at the time you call me and I will be available at this number. If you are unable to reach me, I give my permission for the doctor to do what is medically necessary for my pet.

My signature on this form indicates that any questions I have regarding the procedure, recovery or potential complications have been answered to my satisfaction. I have fully reviewed the estimate for services to be provided.