All on 4 consent form 2025

See details

4 out of 5

22 votes

The document outlines the consent forms for the All-on-4 dental procedure, detailing the treatment process, potential risks and side effects, and the importance of patient cooperation. It covers aspects such as extractions, implant placement, sedation options, post-operative care, and the impact of smoking on implant success. The patient is informed about their responsibilities regarding medication disclosure, oral hygiene, and lifestyle choices that may affect treatment outcomes. Additionally, it emphasizes the need for regular check-ups and provides alternatives to the All-on-4 procedure.

Here's how it works

01. Edit your all on 4 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 hybrid denture consent form via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out all on 4 consent form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the All-on-4 consent form in the editor.
Begin by reviewing the introductory section, which outlines the procedure and potential risks. Ensure you understand each point before proceeding.
Fill in your personal information at the top of the form, including your name and date. This is essential for proper documentation.
Carefully read through each section regarding extractions, implant placement, sedation options, and post-operative care. Use the text boxes provided to indicate your understanding and agreement.
In the photographs section, provide consent by checking the appropriate box. If you have any concerns about this, note them in the comments field.
Finally, sign and date the form at the bottom. Make sure your signature matches your printed name for verification purposes.

Start using our platform today to easily complete your All-on-4 consent form online for free!

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.

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.

What is the All-on-4 protocol?

As a concept, the All-on-4 treatment concept is usually performed in one treatment, which comprises both surgery and prosthetic restoration on the same day. Two straight implants are inserted in the anterior region (usually lateral incisor) and two dorsally tilted implants in the posterior zone (2nd premolar).

What is the downside of All-on-4?

Poor Hygiene Complications If you dont provide it, in addition to the other health problems you could experience, you could develop a condition called peri-implantitis, inflammation in the gums and bone loss around the implant. If left untreated long enough, your All-on-4 could fail.

Will insurance cover All-on-4 dental implants?

Some plans may cover a portion of the cost, while others may not cover All-on-4 implants at all. Reason for the procedure: Insurance companies are more likely to cover All-on-4 implants if the procedure is deemed medically necessary, such as in cases of tooth loss due to injury or gum disease.