The forms listed below are the exclusive property of Greenwoods Dental & Surgical Centres™ and have been created by our team with the utmost care and expertise. These forms are provided solely for the purpose of accurately recording the necessary information and obtaining signatures. Any modification, alteration, or unauthorized change to the content, structure, or design of these documents is strictly prohibited.

Users are permitted only to fill in the required information and sign the forms as provided. Any other form of alteration—including but not limited to editing text, reformatting, or incorporating additional content—is not allowed and may be subject to legal action. By using our forms, you acknowledge and agree to abide by these terms, ensuring that the integrity and proprietary nature of our documents remain intact.

For any questions or requests regarding the appropriate use of these forms, please contact us.

To obtain the password in order to download files, please contact us.

Release Forms

Credit Card Authorization

This form authorizes the secure processing of your credit card payment for specified transactions.

Download
Medical Records Release Form

This form authorizes the release of a patients medical records to our office, detailing the information to be shared and ensuring consent for disclosure.

Download
X-Ray Release & Request Form

This form authorizes the release of Patient X-ray images and related records to designated recipients and allows Patients to request additional X-ray examinations as needed.

To Greenwoods From Greenwoods

Consent Forms

Bone Graft Consent

This form explains graft options, risks, and healing factors so you can make an informed choice—read, ask questions, then sign before surgery.

Download
Crown Lengthening Consent

Outlines the procedure, healing expectations, and risks. Read, clarify any concerns, then sign to authorize treatment.

Download
Dental Bridge Consent

Explains why a bridge is advised, key risks (sensitivity, root-canal or gum surgery, bite changes), and the need to finish treatment and maintain good oral care—read, clarify, sign.

Download
Dental Crown Consent

Explains why a crown is needed, outlines possible risks (sensitivity, root-canal or gum surgery, bite changes), and confirms your agreement to proceed. Read, clarify concerns, then sign.

Download
Dental Treatment Consent

Approves treatment and anesthesia, notes risks and payment terms, and authorizes insurance billing; read, clarify, sign.

Download
Endodontics Treatment Consent

Explains root-canal purpose, success rate, key risks (instrument breakage, infection, retreatment or extraction) and need for a timely crown/filling—read, clarify questions, then sign.

Download
Extraction Consent Form

Explains purpose and risks of tooth extraction—from pain and infection to rare nerve effects—and confirms post-op care; read, ask questions, then sign.

Extraction I Extraction II
Financial Policy Consent

Explains how we handle claims (work plans, JP, NIHB, multiple insurers), assign benefits to us, and notes you’re responsible for any balance—read, ask questions, then sign.

Download
Gingival Grafting Consent

Outlines the gum-graft procedure, potential risks, and required follow-up; review, ask questions, then sign.

Download
Implant Consent

Two-page implant consent outlining treatment, alternatives, risks, follow-up duties, photo release, and signature lines for patient, providers, and witness.

Download