Dentists must obtain informed consent for every treatment you propose and perform on patients or from the patient's legal guardian or decision-maker. I acknowledge that I have the right to refuse treatment at which time I must sign the proper refusal forms.I am provided with this refusal form and information so I may understand the recommended treatment and the consequences of refusing treatment. Claim Forms, Group Dental Claim Form, Group Dental Claim Form - ESP, Individual Dental Claim Form, Individual Vision Claim Form, EyeMed Reimbursement Form. Start treatment immediately and pay over time with low monthly payments. If you choose this option, you can fill out a CareCredit application at our office. Thoroughly complete the claim with clear, legible information. Do not use patients' nicknames. See why 50000 dentists trust Vyne Dental. Dental health is an important part of people's overall health.