{"id":7198,"date":"2019-09-09T19:31:03","date_gmt":"2019-09-09T19:31:03","guid":{"rendered":"https:\/\/www.antoinedentalcenter.com\/?page_id=7198"},"modified":"2025-01-14T21:15:58","modified_gmt":"2025-01-14T21:15:58","slug":"formularios-de-consentimiento-de-houston","status":"publish","type":"page","link":"https:\/\/www.antoinedentalcenter.com\/es\/formularios-de-consentimiento-de-houston\/","title":{"rendered":"Formularios de consentimiento"},"content":{"rendered":"

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Consent Forms<\/h1>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ custom_padding=”|||” border_color_all=”#3b4147″ border_width_left=”8vw” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT FOR ROOT CANAL THERAPY<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

CONSENTIMIENTO INFORMADO: Tratamiento Endod\u00f3ntico (canal de la ra\u00edz)<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT FOR IMPLANTS<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]CONSENTIMIENTO INFORMADO PARA IMPLANTES[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ background_color=”#f7f7f7″ custom_padding=”|||” border_color_all=”#545f66″ border_width_left=”8vw” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Delivery<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Delivery- Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Extraction of tooth which can be saved consent form[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Extraction of tooth which can be saved consent form-Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ custom_padding=”|||” border_color_right=”#ffba60″ border_width_left=”8vw” border_color_left=”#ffba60″ locked=”off” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT For Restorations, Crowns, and Bridges<\/p>\n

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INFORMED CONSENT For Restorations, Crowns, and Bridges- Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT FOR Partial and\/or Dentures<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT For Partial and\/or Dentures- Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ background_color=”#f7f7f7″ custom_padding=”|||” border_color_right=”#ffba60″ border_width_left=”8vw” border_color_left=”rgba(255,186,96,0.6)” locked=”off” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]INFORMED CONSENT FOR ORAL SURGERY AND ANESTHESIA[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]CONSENTIMIENTO INFORMADO PARA CIRUG\u00cdA ORAL Y ANESTESIA[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Medical History[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Historial m\u00e9dico[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ custom_padding=”|||” border_color_all=”#3b4147″ border_width_left=”8vw” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Office Policy[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]pol\u00edticas de oficina[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Financial Policy[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Pol\u00edtica financiera[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ background_color=”#f7f7f7″ custom_padding=”|||” border_color_all=”#545f66″ border_width_left=”8vw” global_colors_info=”{}”][et_pb_row column_structure=”1_5,1_5,1_5,1_5,1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Patient Information[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Informaci\u00f3n del paciente[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]Teledentistry – Electronic Consultation[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_image src=”\/\/i0.wp.com\/antoinedentalcenter.com\/wp-content\/uploads\/2019\/09\/hipaa.png” url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=57068047-d056-42cb-8d35-00ceaf5f97ad” _builder_version=”4.16″ global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]HIPAA Notice of Privacy Practices – Spanish[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_image src=”\/\/i0.wp.com\/antoinedentalcenter.com\/wp-content\/uploads\/2019\/09\/hipaa.png” url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=d68329c0-d2b0-48ce-b95d-953a6a2ae709″ _builder_version=”4.16″ global_colors_info=”{}”][\/et_pb_image][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]HIPAA Notice of Privacy Practices[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ custom_padding=”|||” border_color_right=”#ffba60″ border_width_left=”8vw” border_color_left=”#ffba60″ locked=”off” global_colors_info=”{}”][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Prophylaxis, Gross Scale & Deep Scaling (Cleaning)<\/p>\n

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Prophylaxis, Gross Scale & Deep Scaling (cleaning) – Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Informed consent for Whitening\/Bleaching Treatment<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=953c59dc-a3f4-4066-afef-41de2428ce74″ global_colors_info=”{}”]<\/p>\n

Informed consent for Whitening\/ Bleaching Treatment – Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Project Section 01″ _builder_version=”4.16″ background_color=”#f7f7f7″ custom_padding=”|||” border_color_right=”#ffba60″ border_width_left=”8vw” border_color_left=”rgba(255,186,96,0.6)” locked=”off” global_colors_info=”{}”][et_pb_row column_structure=”1_5,1_5,1_5,1_5,1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED CONSENT Inhalation Sedation (Nitrous Oxide-Oxygen)<\/p>\n

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INFORMED CONSENT Inhalation sedation (nitrous oxide-oxygen)- Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Tooth extraction<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Tooth Extraction- Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED REFUSAL OF TREATMENT<\/p>\n

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INFORMED REFUSAL: Periodontal scaling and root planning<\/span><\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

INFORMED REFUSAL: Periodontal scaling and root planning- SPANISH<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Medical History Update<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Medical History Update-Spanish<\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_5″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Informed refusal of treatment-spanish<\/span><\/p>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_4,1_4,1_4,1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=59d670ab-48dc-484f-9534-b1464b89d2cd” global_colors_info=”{}”]<\/p>\n

Bone Graft Consent Form<\/strong><\/p>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_blurb title=”Upload ID Form” url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=6de3073a-63fd-435b-94a3-f029c191b367″ image=”https:\/\/www.antoinedentalcenter.com\/wp-content\/uploads\/2020\/05\/6D7A48FB-48D0-4C42-A5A0-171B31A20AE3_1_201_a.jpeg” _builder_version=”4.16″ header_font=”|700|||||||” link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=6de3073a-63fd-435b-94a3-f029c191b367″ global_colors_info=”{}”][\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_blurb title=”Upload Lab Slip” url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=1694e64b-acdc-4241-9bdc-e128b7a84544″ image=”https:\/\/www.antoinedentalcenter.com\/wp-content\/uploads\/2020\/05\/Document-flow-icon.png” _builder_version=”4.16″ header_font=”|700|||||||” link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=1694e64b-acdc-4241-9bdc-e128b7a84544″ global_colors_info=”{}”][\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_blurb title=”Orthodontic Evaluation” url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=6667f4e0-8c14-4d70-b8c7-b04a5d078295″ image=”https:\/\/www.antoinedentalcenter.com\/wp-content\/uploads\/2020\/05\/IMG_7092-scaled.jpg” _builder_version=”4.16″ header_font=”|700|||||||” link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=6667f4e0-8c14-4d70-b8c7-b04a5d078295″ global_colors_info=”{}”][\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ global_colors_info=”{}”]<\/p>\n

Dr. Bader Abdeen Consent Forms<\/strong><\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_3,1_3,1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=a26d7c86-3084-4fe5-a861-82bd138c8f76″ global_colors_info=”{}”]<\/p>\n

Consent for Periodontal Surgery<\/strong><\/h3>\n

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Consent for Ridge Augmentation<\/strong><\/h3>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=e685e82a-a607-4327-aa00-5c348c1924d8″ global_colors_info=”{}”]<\/p>\n

Consent for Gingival Graft (Gum Graft) Surgery<\/strong><\/h3>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_3,1_3,1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=0f648e62-ad7a-4dcf-996b-0643cc60bcaf” global_colors_info=”{}”]<\/p>\n

Consent for the use of Bone Regenerative Procedures<\/strong><\/h3>\n

[\/et_pb_text][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_text _builder_version=”4.16″ link_option_url=”https:\/\/app.operadds.com\/Forms\/SetForm?cfId=bf2a303a-74b0-474b-a63f-3a240cb38d1d” global_colors_info=”{}”]<\/p>\n

Informed Consent Bone Graft and Sinus Lift Surgery<\/strong><\/h3>\n

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Consent for the Placement of Dental Implants on<\/strong><\/h3>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Consent FormsINFORMED CONSENT FOR ROOT CANAL THERAPYCONSENTIMIENTO INFORMADO: Tratamiento Endod\u00f3ntico (canal de la ra\u00edz)INFORMED CONSENT FOR IMPLANTSCONSENTIMIENTO INFORMADO PARA IMPLANTESDeliveryDelivery- SpanishExtraction of tooth which can be saved consent formExtraction of tooth which can be saved consent form-SpanishINFORMED CONSENT For Restorations, Crowns, and BridgesINFORMED CONSENT For Restorations, Crowns, and Bridges- SpanishINFORMED CONSENT FOR Partial and\/or DenturesINFORMED […]<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-7198","page","type-page","status-publish","hentry"],"yoast_head":"\nConsent forms - Antoine Dental Center<\/title>\n<meta name=\"description\" content=\"Find Antoine Dental Center consent forms here. 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