Common Contracts

2 similar Patient Agreement contracts

PATIENT AGREEMENT & CONSENT FORM
Patient Agreement • February 11th, 2013

Most risks are related to the position of the nerves under the tissue, at the site of the injection, which cannot be determined prior to the administration of the anesthetic agent. Although the risks seldom occur they might include loss of sensation of the tongue and lip. If this occurs it is often temporary and normal sensation usually returns. However, in very rare cases the loss of sensation may extend for a longer period and may become permanent. In addition, injecting a foreign substance into the body such as an anesthetic agent may result in an allergic reaction. Allergic reactions to these agents are rare, but may take place.

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PATIENT AGREEMENT & CONSENT FORM
Patient Agreement • February 11th, 2013

Most risks are related to the position of the nerves under the tissue, at the site of the injection, which cannot be determined prior to the administration of the anesthetic agent. Although the risks seldom occur they might include loss of sensation of the tongue and lip. If this occurs it is often temporary and normal sensation usually returns. However, in very rare cases the loss of sensation may extend for a longer period and may become permanent. In addition, injecting a foreign substance into the body such as an anesthetic agent may result in an allergic reaction. Allergic reactions to these agents are rare, but may take place.

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