Treatment Estimate

An all-purpose treatment conference tool

This form may be used for all types of treatment conferences. It documents exact financial arrangements and co-payments for your patient and supplements the informed consent process. (Click on Informed Consent Forms on products page). Use this form to eliminate disputes over finances and treatment.

• Financial arrangements to fit any office
• Service Charge - implement if applicable
• Dental Insurance - patient responsibility
• Informed Consent
• Most common dental treatment procedures listed on one easy - to - use form

To preview
Sample Form in PDF format

CLICK HERE

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