Record

PATIENT CONSENT FOR AUDIO RECORDING

I hereby consent to the audio recording of my dental appointment on the date specified above. I understand and agree to the following:

1. This recording will be used solely for the purpose of generating clinical documentation (SOAP notes) for my dental visit.

2. The recording will be processed using artificial intelligence (AI) technology to create accurate clinical notes.

3. My recording and resulting documentation will be stored securely with encryption and accessible only to authorized dental staff.

4. I may request to revoke this consent at any time by notifying the dental office.

5. No personally identifiable health information beyond what is necessary for clinical documentation will be shared with third parties.

This consent is valid for all recordings made for the undersigned patient on the specified date of visit.