Thank you for your inquiry.
I am not aware of, nor could I find with a literature search, any standardized consent forms specifically for local anesthetic testing. However, there are two generic drug testing/challenge consent forms that you can use and simply modify to suit your purpose. I have copied links to these forms below. They are extremely comprehensive, and either one will do if you modify it, but if you wish to be more comprehensive, you can combine the two and modify it specifically for local anesthetic testing.
There is also copied below a link to a consent form for food testing which should serve your purposes specifically and of course this can be modified as well.
Thank you again for your inquiry and we hope this response is helpful to you.
generic consent form oral challenge
Generic consent form for drug testing and challenge
Consent form for food challenge
Phil Lieberman, M.D.