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Consent for Composite or Porcelain Veneers Mobile App

Veneers are thin layers of porcelain or composite resin that are placed on the front of surfaces of teeth in order to give you a smile makeover.

This Consent for Composite or Porcelain Veneers mobile app outlines the differences between composite and porcelain veneers. It also highlights risks and complications that may be experienced during the dental treatment and cosmetic procedure. The app also includes signature capture to give inform consent to the veneer treatment procedure.

This orthodontic treatment plan app can be downloaded to an iPhone, iPad, or Android device. All consent forms are saved in the GoCanvas Cloud and can be printed or emailed as a PDF if you need to share them with others.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Consent for Composite or Porcelain Veneers Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico statictext

    Veneers are thin layers of porcelain or composite resin that are placed on the front surfaces of ...

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    The procedure for placing Porcelain Veneers involves a series of appointments in which your input...

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    The goal of composite veneers is the same as porcelain veneers but the materials, techniques, and...

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    Potential Risks and Complications:

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    In preparing the teeth for the reception of cosmetic veneers, either made of porcelain or compos...

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    Sensitivity of teeth: Through the process of modifying teeth to accept veneers, there is the pos...

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    Chipping, breaking or loosening of the veneer may occur any time following placement.

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    Alteration in speech: Since the veneers may be wider and/or longer than the natural teeth they a...

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    Sensitive or allergic reactions to anesthetics or materials used in the procedure.

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    Esthetics/Appearance: Every attempt possible will be made to match and coordinate both the form ...

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    Longevity: It is impossible to place any specific time criteria on the length of time that venee...

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    Veneers are susceptible to staining just like natural teeth.

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    An acrylic lab fabricated night guard may be indicated to help protect your veneers from damage ...

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    I certify that I have read the above and fully understand this consent for treatment.

  • Ico signature

    Patient Signature

  • Ico date

    Date

  • Ico signature

    Doctor Signature

  • Ico date

    Date

  • Ico signature

    Witness Signature

  • Ico date

    Date

  • ...and More!

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