Biopsy Consent

Home / New Patients / Patient Forms / Consent Biopsy

Consent Biopsy

Schedule Your Consultation Today!

Appointments

New Patients

Welcome
Before and After Photos
Dr.’s Wall of Fame
Patient Testimonials
Video Testimonials
Patient Forms
Reference Page

Ask the doctor

Name:*
Email:*
Phone:
Message:
CAPTCHA

Consent for Biopsy

Consent for Biopsy
Biopsy specimens are recommended from each cavitation and extraction site. These specimens may be submitted for either pathology reports, or toxicology reports, depending on which report the doctor feels is most beneficial. Due primarily to financial reasons, we understand that some patients do not wish to have biopsy specimens submitted from each surgical area.
Please Check One
- I the undersigned wish to have every surgical site or extracted tooth submitted for a pathology or toxicology report.
- I the undersigned wish to have Dr. Wall submit only those specimens which he feels are absolutely necessary for diagnostic purposes.
- I the undersigned DO NOT wish to have ANY biopsy performed. I choose this option for financial reasons. I understand this is contrary to Dr. Wall’s recommendations.
There is a charge from the pathology lab, unless covered by your insurance, typically $150.
Printed Name*
First Name Last Name
Signature*
Date*
MM slash DD slash YYYY
CAPTCHA

After submitting, feel free to return to the Patient Forms page. Please note, there are multiple forms for each section.

Schedule Your Consultation Today!

(801) 298-1812

Schedule Your Appointment with the Holistic Dentist

Every service we offer is aimed at improving your overall health. We offer several procedures that eliminate the need for surgical incisions, reducing your discomfort, downtime, and the need for multiple visits. Call our office to schedule your consultation today.

Appointments

Our office

Dental Solutions, Inc
Dr. Judson Wall
235 S 400 E
Bountiful, UT
84010
Phone: (801) 298-1812

About Our Practice

Meet Dr. Wall
Meet The Staff
Patient Testimonials
Before and After Photos
Financial Policy
Office Directions

Featured Treatments

Mercury Free Dentistry
Root Canal Removal
Cavitation Surgery
Pinhole Surgical Technique
Zirconia Dental Implants
Digital Impressions
CARESTREAM
One Visit Crowns

Dr Montes seen both of my kids and was absolutely amazing, they felt no pain, very comfortable the whole time. They loved it there! They were both scared to go and now they both can't wait to go back!

Kierston Kirby

May 24, 2022.

I feel very fortunate to have found Dental Solutions. The dentists and the staff are outstanding! I have had health issues for many years and had this underlying, nagging feeling that was just exhausting. I went to Dental Solutions and had cavitation surgery and other dental work clean up, and that underlying nagging feeling is gone and my energy has returned! I would highly recommend them.

Tina Clifford

June 28, 2021.

The doctors and supporting staff are wonderful, and have helped me take control of my health through corrective dental work. It’s so nice to have a consultation with professionals who really care about you and your life!

Bonita Richins

June 18, 2021.

Dr Montes is a very knowledgeable dentist, and the whole staff is very fun and professional.

Coz

June 14, 2021.

The doctors and staff at Dental Solutions are exceptional. I have been going since 2015 and have received the best of care. Dr. Wall is a great dentist with much knowledge and expertise. He and the staff make sure you are comfortable and have all your questions answered. Kris is the best and most thorough hygienist. Highly recommend!

Marianne Austin

June 2, 2021.

Dr. Wall is a living legend in our family! He has helped me recover from poorly done root canals, fixed years worth of incorrect orthodontics, and solved my TMJ problems. I struggled with chronic vertigo during and after my pregnancy that was passed off as “normal” hormonal changes. I saw multiple doctors and neurologists before visiting Dr. Wall. He discovered 4 cavitations that needed addressing and once he worked his dental magic, the vertigo I had struggled with daily for 2 years disappeared! The importance of proper dental care for overall health cannot be overlooked. Dr. Wall is the best in his field and it’s an honor to have him on my healthcare team!

Missy Beavers

May 26, 2021.

I highly recommend Dr. Wall to anybody with tooth aches or pains. He is so caring and understanding. He has genuine concern for my well being. His staff is very nice and professional. I can't say enough good things about the care I received from Dr. Judson Wall and his team. Thank-you!

Tyler Heath

May 26, 2021.

I had so much discomfort for years and Dr Wall took out teeth that were gangrene that I did not know were that bad. He is amazing....

Beatrice Ireland

May 24, 2021.

Hands down the most amazing dentist I've ever been to. From the expertise of care and heartfelt communication from Dr. Wall and his staff to the lush jungle of plants throughout the office, this is a dental experience like no other. For 15 years I had been struggling with a phantom disease causing chronic fatigue, brain fog, anxiety, depression, etc...it was hell. A woman (who I now feel is certainly a guardian angel) brought to my attention that my story was almost identical to the man who produced the film "Root Cause". I was taken aback that my issues could actually be caused by an old root canal I had and felt compelled to watch it...it made me cry and I knew this was it. She then referred me to Dr. Wall and the rest is history. I spent about 4 hours at Dental Solutions my first visit where I received a level of care you wouldn't expect from a dentist, let alone your family doctor. Being a biological practice, Dental Solutions has your whole body in mind and I was tested from head to toe to figure out what was going wrong. Sure enough, I had a failed root canal that had eaten a 1 cm diameter hole in my jaw above that tooth...it was slowly killing me. Dr. Wall pulled the decayed tooth which was gangrenous, cleaned everything out, stuffed the decayed hole with platelet rich fiber (PRF) and put a zirconia implant in. He also cleaned out my wisdom tooth cavitations and did TMJ injections to help the jaw issues I didn't realize I had. Over one year later and I feel better than ever, I have my vitality back!!!! So very thankful for Dr. Wall, he saved my life. No other dentist had any idea what was going on. This is the place to go, I travel from Colorado to come here...highly recommend this practice. Thank you Dental Solutions for changing my life!

Alex Curry

May 13, 2021.

Reviews

235 South 400 East, Bountiful, Utah, 84010

(801) 298-1812

New Patients

Ask the doctor

Consent for Biopsy

Consent for Biopsy

Our office

About Our Practice

Featured Treatments

Follow us