Gingival Therapy Refusal

Gingival Therapy is very important step for our patients who are tending in the direction of periodontal disease. If after being educated on the importance of completing their recommended Gingival Therapy treatment, they refuse treatment the patient would need to fill out the form below. This documents that we told them everything they need to know about the treatment and the benefits and they are still refusing and know this could lead to more dramatic and costly treatment be recommended down the road.

Refusal form