HomeClient CenterOnline FormsDental Consent Form Dental Consent Form Cleaning & PolishingCleaning & Polishing*I authorize the cleaning and polishing of my pet’s teeth.I decline the cleaning and polishing of my pet’s teeth.Digital Dental ImagesOur hospital requires full-mouth digital x-ray images be completed every 12 months in order to best assess your pet’s oral health.My pet has had a dental image survey taken within the last 12 months:*YesNoDate Taken* Date Format: MM slash DD slash YYYY Controlling & Treating Early Stages of Periodontal DiseasePeriodontal disease is responsible for the loss of teeth and can contribute to heart and kidney diseases. Your pet likely has active periodontal disease; to treat periodontal disease and attempt to halt further tooth loss, it may be necessary to treat the gums directly.Periodontal Treatment*I authorize this treatment as recommended by the doctor.I decline this treatment as recommended by the doctor.ExtractionsWhen the periodontal disease is too advanced or the tooth has become damaged beyond repair, the veterinarian will likely recommend surgical extraction. The most common reasons for a surgical extraction are: damaged or fractured tooth, abscess, advanced periodontal disease. If these teeth are not surgically extracted, they can be a constant source of pain and discomfort, and worse, be a source of infection that continues to spread.After-Cleaning Home CarePreferred Type of Medication*If medication is sent home, please select your preferred medication form.Tablets/CapsulesLiquidTaking care of your pet’s teeth on a daily basis will help to maintain the clean teeth they leave with today.How you would like to continue your pet’s oral healthcare at home?*Our doctors recommend the following additions to your daily routine.Toothbrush KitMouth rinseOravet dental chews with sealantOral hygiene water additiveEnzymatic Rawhide chewHome Care Product* Please perform indicated procedures & extractions are required at this time. Please perform indicated procedures & extractions are required up to the amount below. Please do nothing more than the requested dental prophylaxis procedure at this time. Please call me if any additional procedures are needed. Do not proceed without authorization. Procedure Amount*Name* First Last Pet's Name*Email* CommentsThis field is for validation purposes and should be left unchanged. Get Directions Appointments We will do our best to accommodate your busy schedule. Schedule an appointment today! Request An Appointment Request A Boarding Reservation Please complete the appropriate form to request an appointment. Please note that you do not have an appointment until you receive confirmation from us. Thank you!