CONSENT FOR USE OF GRAFTING MATERIALPlease enable JavaScript in your browser to complete this form.CONSENT FOR USE OF GRAFTING MATERIAL FOR RIDGE PRESERVATION / AUGMENTATIONBone loss is inevitable following extractions (performed in the past or present). Bone / Tissue grafting can lessen the extent of the bone loss and/or restore deficiencies.GRAFTING MATERIALS:Hydroxyapatite Graft (Sterile) – Laboratory synthesized calcium apatite used as filler for the purpose of bone growth.Calcium Sulphate / Phosphate (Sterile) – Laboratory processed calcium material used as a filler for the purpose of bone growthBovine Bone Graft (Sterile) – Composite anorganic bovine-derived bone material & synthetic peptideAllograft (Sterile) – Commercially prepared laboratory processed human donor bone Autograft – Bone material harvested from another part of your own bodyCollagen Membrane / Barrier (Sterile) – Laboratory processed purified protein barrier derived from animal (bovine/porcine/human) sourceTitanium Mesh/Netting (Sterile) – Commercially prepared non-absorbing mesh to contain the graft material for a temporary period. After a short healing period, it will need to be removed.No Graft electedADJUNCTIVE PROCEDURES:I also consent for use of Adjunctive Procedures which can facilitate a more successful outcome:Platelet Rich Fibrin – Concentrated natural fibrin clot isolated from your blood for facilitating tissue healingBotox Therapy – Purified proteins administered to temporarily relax/reduce the damaging forces of clenching/chewing musclesI have had the above options explained to me and have had my questions answered to my satisfaction by Doctor. I elect/consent to have the above choice(s) performed by:Doctor: *ChahalHsuParticipant's Name *FirstLastParent/Guardian Name *FirstLastEmergency Contact Number *Consent *Please tick the box to agree.Signature *Clear SignatureDate *Submit