---
title: Dental Sedation Consent Form Template | Paperform
description: Professional dental sedation consent form with medical history review, fasting instructions, sedation level options, and transportation requirements. Customizable and HIPAA-adjacent compliant.
url: "https://paperform.co/templates/dental-sedation-consent-form"
type: static
generatedAt: "2026-03-28T00:43:39.843Z"
---

[← Back to free form templates](/templates/)    ![Dental Sedation Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dental-sedation-consent-form.png)
    [Preview](https://_preview.paperform.co/ai-template/dental-sedation-consent-form) [Use this template for free](/create?ai-template=dental-sedation-consent-form)    [Healthcare & Medical Forms](/templates/category/healthcare/)[Legal & Compliance Forms](/templates/category/legal/) [Healthcare](/templates/industry/healthcare/)[Dental](/templates/industry/dental/) [Physician](/templates/role/physician/)[Dentist](/templates/role/dentist/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
### Safe and Compliant Dental Sedation Consent

Dental sedation is a common procedure that requires careful documentation, patient education, and informed consent. This **dental sedation consent form template** helps dental practices streamline their sedation workflow while ensuring full compliance with medical and legal requirements.

Whether you're administering nitrous oxide, oral conscious sedation, or IV sedation, this form captures everything you need: detailed medical history, current medications, fasting compliance confirmation, sedation level selection, and verification of post-procedure transportation arrangements.

#### Built for dental practices that prioritize patient safety

This template is designed specifically for general dentists, oral surgeons, periodontists, and pediatric dentists who offer sedation dentistry. It walks patients through critical pre-sedation requirements—including fasting instructions and medical contraindications—while collecting legally required consent signatures.

With Paperform, you can customize this template to match your practice's branding, embed it directly into your patient portal, and automatically send confirmation emails with pre-appointment instructions. Conditional logic ensures patients only see relevant questions based on their medical history and chosen sedation level.

#### Streamline sedation workflows with automation

Connect this form to your practice management software using **Stepper** (stepper.io) to automatically:

 - Update patient records with sedation consent status
 - Send pre-appointment reminders about fasting requirements
 - Alert staff when high-risk patients require additional review
 - Create post-procedure follow-up tasks for recovery monitoring

You can also use **Papersign** (papersign.com) to collect legally binding electronic signatures from both the patient and responsible adult, creating a complete audit trail that's stored securely with the original form submission.

#### Designed for healthcare compliance and patient trust

This template includes all standard sedation consent elements: medical history screening, allergy documentation, medication interactions, NPO (nothing by mouth) compliance verification, and acknowledgment of risks and benefits. Every submission is encrypted and stored securely, helping your practice maintain HIPAA-adjacent best practices while delivering a smooth, professional patient experience.

Trusted by dental practices worldwide, this Paperform template combines the flexibility of a document editor with the power of automated workflows—so you can focus on patient care, not paperwork.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
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