Dental Treatment Plan Approval Form

Streamline Dental Treatment Approvals with Paperform

Getting patient approval for dental treatment plans shouldn't involve stacks of paperwork and manual signatures. This Dental Treatment Plan Approval Form template gives dental practices, orthodontists, and oral surgeons a professional, digital-first way to present treatment options, break down costs transparently, and capture patient authorization—all in one secure, HIPAA-ready form.

Whether you're proposing routine restorative work, cosmetic procedures, or complex surgical interventions, this template helps you clearly communicate the recommended treatment, itemized costs, insurance coverage estimates, and alternative options. Patients can review everything at their own pace, ask questions, and provide their digital signature to authorize the plan—eliminating paperwork delays and reducing administrative burden on your front desk.

Built for modern dental practices

This form is designed specifically for dental offices that want to:

• Present treatment plans clearly: Break down each procedure with descriptions, costs, and timeframes so patients understand exactly what's being recommended
• Estimate insurance coverage: Include fields for insurance details, coverage estimates, and patient responsibility so there are no billing surprises
• Offer alternatives: Give patients visibility into alternative treatment options with different cost and complexity levels
• Capture secure authorization: Use Paperform's built-in signature field to collect legally binding patient consent without printing, scanning, or faxing

Beyond the form itself, you can connect submissions to your practice management software, send confirmation emails with treatment summaries, and use Papersign to route more complex consent forms or financing agreements for eSignature as part of your approval workflow.

Automate what happens next with Stepper

Once a patient submits their approval, you can use Stepper to automatically:

• Create or update the patient record in your dental practice management system
• Notify the treatment coordinator and scheduling team
• Send insurance verification requests
• Trigger pre-appointment reminders and pre-medication instructions
• Update financial records and generate payment plans

This template is ideal for general dentists, specialists, dental surgeons, and multi-location practices that handle high volumes of treatment plans and want to reduce paperwork, speed up approvals, and improve the patient experience. With Paperform's conditional logic, you can customize the form to show different fields based on treatment type, insurance status, or financing needs—keeping the experience relevant and streamlined for every patient.