Intraoral Photography Consent Form

Patient Name: Date of Birth: Date:

Consent for Intraoral Photography

I acknowledge and consent to the taking of intraoral photographs as part of my dental examination and treatment. These photographs may be used for diagnostic, clinical, educational, or record-keeping purposes.

I consent to the use of my intraoral photographs for diagnosis and treatment planning. I consent to the use of my intraoral photographs for educational purposes (e.g., presentations, teaching). I consent to the use of my intraoral photographs for publication or promotional materials.

Additional Notes or Restrictions: