Part two of our written informed consent series focuses on signatures.
Best practice is to have patients sign the written informed consent on the date of treatment. The consent also may be signed during an earlier treatment planning appointment. However, if a significant amount of time passes between treatment planning and treatment delivery, it may be advisable to have the patient resign the consent so that the signature is contemporaneous with treatment. Also be sure the patient dates their signature when signing the informed consent.
Board rules do not require that the dentist sign the written informed consent. However, it can be an advisable practice because it provides the dentist with an opportunity to review the consent for accuracy. Has the patient signed the form? Is the form dated? Is the correct quadrant, arch and/or tooth identified? Was the correct form used, and does it address the procedure(s) to be completed? These are all issues the dentist must confirm to ensure compliance with the recordkeeping rules.
Consent forms sometimes include a space for a witness signature. Dentists frequently have a staff member sign in this spot. Board rules do not require a witness signature on a written informed consent so it is up to the dentist whether to require that step.
Dentists sometimes have concerns when a stepparent consents to a child’s treatment. Generally, dentists can take the word of a stepparent regarding their authority to consent. If questions exist, a dentist can request that the consent be signed by a biological parent instead of a stepparent. A dentist also can ask for a copy of the custody order to confirm who is authorized to consent to treatment for the child.
Chapter 32 of the Texas Family Code provides information about who can consent to the treatment of minors. Dentists should understand who can (and who cannot) provide consent since informed consent must be obtained from a person with authority. For example, pursuant to Chapter 32, grandparents, adult siblings and adult aunts/uncles may consent to dental treatment for a child “when the person having the right to consent as otherwise provided by law cannot be contacted and that person has not given actual notice to the contrary.” https://statutes.capitol.texas.gov/ Dentists would be wise to familiarize themselves with the requirements of this statute.
Laura Diamond is an administrative and healthcare attorney based in Austin, Texas with a statewide practice representing dentists before the Texas State Board of Dental Examiners. Ms. Diamond can be reached at ldiamond@dsedlaw.com or (512) 472-4845. © Laura Diamond 2025. This article is not legal advice.
Duane Tinker is the CEO of Dental Compliance Specialists, a healthcare compliance consulting firm in Fort Worth, Texas. Mr. Tinker can be reached at duane@dentalcompliance.com or (817) 755-0035.