Skip to Main Content

Sample Forms

We’re here to make record keeping easier and more efficient so you can better protect your practice. View, download and customize the right resources for your state. Find sample forms and letters to support documentation, employment, general liability and patient care.

Authorization for Care-taker to Accompany a Minor

Sample form to authorize a non-legal guardian to accompany a minor patient to dental appointments.

Dispensing Products Acknowledgment form

Sample acknowledgment form to document products dispensed to a patient. Does not apply to medications.

Informed Consent Declaration

Sample form for a non-legal guardian to authorize dental treatment on a minor patient.

Office Closure Checklist

Sample office closure checklist to minimize property damage, secure the premise, and protect assets.

Patient Dismissal Letter

Risk Management analysts offer assistance with patient dismissal letters. Contact the Advice Line for support.

Download Tip Close

Some browsers will provide an option to save the file to your computer/device, others will automatically download the file to your downloads/files folder.

Explore More Resources

Access a dentistry-focused risk management articles, guides, sample letters, informed consent forms and more.