I UNDERSTAND that IMPLANTS AND PROSTHODONTIC DEVICES (crowns, bridges, dentures) placed over implants include possible inherent risks such as, but not limited to the following and I agree to assume any and all such risks:
INFORMED CONSENT: I have been given the opportunity to ask any questions regarding the nature and purpose of the implants and prosthetics relating to implants and have received answers to my satisfaction. I do voluntarily assume any and all possible risks, including risk of substantial harm, if any, which may be associated with any phase of this treatment in hopes of obtaining the desired potential results, which may or may not be achieved. No guarantees or promises have been made to me concerning my recovery and/or any results from the treatment to be rendered to me. The fee(s) for these services have been explained to me and I accept them as satisfactory. By signing this form, I am freely giving my consent to authorize Dr. Craig Smith and/or all associates involved in rendering any services he/she deems necessary or advisable to treatment of my dental conditions, including any anesthetic agents and medications.