Periodontal Treatment Consent Form – Austin City Dental
Please review and complete your Periodontal (Perio) Treatment ConsentBefore beginning periodontal therapy—such as scaling and root planing, periodontal maintenance, or other gum treatments—we ask patients to complete this secure consent form. It explains the purpose of treatment, expected benefits, potential risks, and the importance of follow-up care. Once submitted, the form is encrypted and sent directly to our team.
Completing this form in advance helps us review your medical history and ensures you understand the goals and long-term importance of periodontal therapy.


Submitting your consent form ahead of time allows you to review the details of periodontal treatment and understand how gum disease is managed long-term. It also helps our team prepare the appropriate treatment plan and ensures your appointment runs smoothly and efficiently.