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Dental Marketing Consent

Patient consent for use of photos, testimonials, and reviews in marketing.

Preview Form
  • 7 days free
  • Cancel any time
  • 10 languages
  • No patient data stored on our servers
Fields
7
Practice type
Dental
Languages
English
Editable
Yes — add, remove and reword fields
Sharing
Print, PDF or a secure link

Dental Marketing Consent — preview

Sample layout generated from the actual template.

Patient Namerequired
I consent to use of my testimonial
I consent to use of my before/after photos
I consent to use of my name with reviews
I understand I can revoke this consent at any timerequired
Patient Signaturerequired
Daterequired

Free to start — your edits are saved as you go.

About this form

The dental marketing consent is a legal & compliance document used by dental practices. Patient consent for use of photos, testimonials, and reviews in marketing. In BoomCloud Forms it is a starting point: every field, heading and statement can be edited before you share it with patients.

Practices may use this template as a starting point and should review the wording against their own professional, regulatory and legal requirements before use.

What's included

This template ships with 7 fields:

  • Patient NameText
  • I consent to use of my testimonialMultiple choice
  • I consent to use of my before/after photosMultiple choice
  • I consent to use of my name with reviewsMultiple choice
  • I understand I can revoke this consent at any timeMultiple choice
  • Patient SignatureSignature
  • DateDate

When practices use it

Dental teams typically attach this form to the records and compliance workflow, keeping a signed copy in the patient file. It can be sent digitally ahead of the visit, completed on a tablet in the office, or printed as a PDF.

How to customize it

  • Reword any question, add fields, or remove ones your practice doesn't need.
  • Apply your practice name, logo and colors so the form matches your brand.
  • Switch to another supported language where a translated version exists.
  • Share a secure link with the patient, or download a print-ready PDF.

Not ready yet? Email me this template

We'll send a link to the Dental Marketing Consent so you can come back to it later.

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Dental Marketing Consent

7 days free · No card required to start