General Consent to Treatment

As a Houston Tx dentist we ask you to read and acknowledge the following statement. I agree and consent to a dental examination by Dr. David Hassid, DMD, dentist at Hassid Dental. I understand that additional diagnostic procedures and dental treatments may be recommended and will be discussed with me prior to being done. Also, I acknowledge that there are no guarantees, expressed or implied, as to the results of any procedures or dental treatments performed.

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2415 W. Alabama St., Suite 210
Houston, TX 77098

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p: 713.526.2555

f: 713.526.2556