Arestin consent form 2025

Show details

4 out of 5

23 votes

The document is an informed consent form for the use of Arestin in treating adult periodontitis at Chattanooga State Community College. It outlines the purpose of Arestin as an adjunct to scaling and root planning, potential risks, contraindications, and possible side effects. The patient acknowledges understanding the treatment's purpose, risks, and that there are no charges for the procedure.

Here's how it works

01. Edit your arestin consent form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to quickly redact Arestin consent form online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the greatest editor for updating your forms online. Adhere to this simple guideline redact Arestin consent form in PDF format online at no cost:

Register and log in. Create a free account, set a secure password, and go through email verification to start working on your forms.
Add a document. Click on New Document and choose the form importing option: upload Arestin consent form from your device, the cloud, or a protected link.
Make changes to the template. Utilize the upper and left panel tools to modify Arestin consent form. Add and customize text, pictures, and fillable fields, whiteout unneeded details, highlight the significant ones, and provide comments on your updates.
Get your documentation completed. Send the sample to other people via email, create a link for quicker document sharing, export the template to the cloud, or save it on your device in the current version or with Audit Trail included.

Explore all the benefits of our editor right now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the ADA code for ARESTIN placement?

In the Chart Module toolbar, click Consent. Alternatively, in the Treatment Plan Module click Consent. If only one Consent form exists, it is generated. If more than one Consent form exists, click the dropdown, then select the form to generate instead.

What is the code D0120 and D1110?

Most Common Dental Billing Codes D0120 Periodic Oral Evaluation: The essential code for routine check-ups, vital for ongoing oral health assessment. D1110 Adult Prophylaxis: This code applies to routine cleaning procedures for adults, fundamental in preventing dental diseases.

How do I write a consent letter for dental treatment?

I declare that I am more than 18 years of age. I have been informed that there are inherent risks involved in the treatment / procedure. I have signed this consent voluntarily out of my free will without any pressure and in my full senses.

Can I make my own consent form?

Arestin (per site): Code D4381. FDA approved subgingival delivery devices containing antimicrobial medication(s) are inserted into periodontal pockets to suppress the pathogenic microbiota.

What is ADA code D6245?

Dental Code D6245 refers to the procedure known as Pontic - Porcelain/Ceramic in the field of dentistry. This code is specifically used to indicate the fabrication and placement of a porcelain or ceramic pontic, which is an artificial tooth used to replace a missing tooth in a dental bridge.