CONSENT FOR TRY-IN

Patient Name*

First Last

Denturist Name*

First Last

Procedure

In fabricating your denture, it may be necessary to have 1 to 2 try-in appointments. At this time, your teeth will be set in wax, which will allow you to try them on and share your opinion regarding aesthetics and comfort. We encourage you to bring someone you trust to the appointment who will give their honest opinion of your smile.

These try-in appointments also allow the denturist to re-check your bite to ensure the teeth are set properly and that the shade matches any natural teeth you may have (this applies to partial dentures). During this time, you will be able to discuss concerns and request changes to your denture. If more changes are necessary, we will be happy to accommodate additional appointments to meet your needs.

Once you have approved this process, we will ask that you sign below, giving us consent to proceed.

Consent

Consent*

I hereby give consent for the denturist to proceed with the final treatment.*

Patient Signature*

Phone

This field is for validation purposes and should be left unchanged.