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Consent for Drawing Blood and Platelet Rich Fibrin (PRF) for Use in Dental Surgery

My dentist at Lancaster Family Smiles has recommend the use of Platelet Rich Fibrin (L-PRF) to enhance postoperative healing. L-PRF is a component of my own blood. My Blood contains platelets, which have growth factors that help promote soft tissue healing. The PRF procedure was invented in 2001 by Joseph Choukroun MD of France.

My blood will be drawn into several vials. My blood will be placed in a centrifuge, which contrates the platelets. This will activate the platelets, making them release their growth factors.

The blood used is my own. All the materials used for blood drawing, including the needles and all the centrifuge processing containers, are single-use and disposed in our medical waster container after eacg patient’s procedure. Each PRF procedure uses its own materials and supplies, which are completely sterile and clean.

I have had the opportunity to ask questions before signing this consent form, and I understand that I can also ask questions later. After deliberation, I consent to the PRF process.

I can view a detailed medical lecture on PRF online at: http://intra-lock.com/index.php?option=com_content&task=view&id=133&Itemid=79

As a reminder, drink plenty of water 24 hours before your blood is drawn.

I certify that I have read this document.