I am provided with this refusal form and information so I may understand the recommended treatment and the consequences of refusing treatment. Dentists must obtain informed consent for every treatment you propose and perform on patients or from the patient's legal guardian or decision-maker.Members can access dental services through MediCal Dental enrolled providers, who will advise members on the best course of treatment. Take this short quiz to narrow down your choices and see jobs you might be interested in. We're ready when you are. Nothing contained within this website or on any publications or forms found therein is intended to be legal or dental advice. I understand that no dental treatment is completely risk free and that my dentist would take reasonable steps to limit any complications of my treatment. When was the last time you had complete dental x-rays taken? Business owner information.