Informed Consent Form for Local Anesthetic

Comprehensive informed consent for Local Anesthetic, as well as blanks to record blood pressure and pulse on date of procedures.

This form details the risks, hazards and alternative treatments available for most general dentistry procedures. Includes blanks to fill in specific procedures to be performed.

Complies with TSBDE Rule 108.7 which requires that Texas dentists maintain a written informed consent signed by the patient, or a parent or legal guardian of the patient if the patient is a minor, or a legal guardian of the patient if the patient has been adjudicated incompetent to manage the patient's personal affairs.

Watch the explanatory video, below.

Such consent is required for all treatment plans and procedures where a reasonable possibility of complications from the treatment planned or a procedure exists, and such consent should disclose risks or hazards that could influence a reasonable person in making a decision to give or withhold consent.

TSBDE Rule 108.7, Standard of Care and Informed Consent.

For dental professionals seeking legal expertise, information, and counsel, Boyd W. Shepherd, D.D.S., J.D., and The Law Library equip and educate Texas dentists for navigating their legal concerns.


For 20 years, Boyd W. Shepherd, D.D.S., J.D., has been in the business of keeping track of the the law that regulates the dentists of Texas. He has vast experience from Texas State Board representation at each and every level of the process, litigation, and from day-to-day counsel and guidance to dentists across the state of Texas on issues related to their business operations, Board Rule compliance, risk management, employees, and patients.

Bottom line: Comprehensive legal services for Texas dentists.