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Orthodontic Treatment Consent Form

Asks about parent or guardian name, treatment type, and estimated treatment duration. Built for obtaining informed consent before placing braces or starting clear aligner therapy.

Questions
12
Pages
2
Time
about 3 min

Includes

  • E-signature
  • Consent agreement
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Your practice

Orthodontic Treatment Consent Form

Page 1 of 2 · Your information

Live preview. Tap through it like a patient.

Who it is for

  • Obtaining informed consent before placing braces or starting clear aligner therapy
  • Documenting patient understanding of orthodontic treatment duration and risks
  • Recording guardian authorization for minor orthodontic patients
  • Establishing compliance expectations for oral hygiene and appliance care

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What's inside

Before you publish: Add your practice-approved consent wording before publishing.

Page 1 · Your information

  1. Patient Full NameText · Required
  2. Date of BirthDate
  3. Parent or Guardian NameText
  4. Treatment TypeLong Text
  5. Estimated Treatment DurationText

Page 2 · Additional details

  1. Oral Hygiene Requirements AcknowledgedLong Text
  2. Dietary Restrictions AcknowledgedLong Text
  3. Financial Agreement ReviewedConsent Agreement
  4. Consent to TreatmentConsent Agreement
  5. Patient or Guardian SignatureE-Signature

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Orthodontic Treatment Consent Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 12 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Orthodontic Treatment Consent Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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