Please complete every section of this form as it forms part of vital dental / medical records for your child’s treatment.
Does your child have any of the following?
Your specialist maybe working with the assistance of a professionally trained and assessed therapy dog, Comet (labradoodle). We provide this as an additional service; we do not charge an additional fee.
While Comet is well trained and socialised, there are always risks with working with animals. These included the risk of allergies, illnesses and personal injury.
I consent to the presence of a Therapy Dog:
In accordance with the Privacy Act (1988), all information collected by the Paediatric Dental Group is treated as confidential. To protect your privacy and that of your child, the Paediatric Dental Group operates in accordance with this Act.
We may use the information provided in the following ways: