Aligner Consent
Please Read and Sign Below
  • I understand and accept my Orthodontic Case will roughly take 12-24 months and 3 refinements will be included in this cost along with 1 set of retainers at the end of the treatment.

  • I understand that I will need to be seen every 4-8 weeks to have my orthodontic check appointment and need to reserve 30 minutes for each appointment to allow the Doctor/Assistant to review and check the progress of my case and deliver more aligner sets.

  • I am aware failed orthodontic appointments will consist of being uncompliant and may result in my current aligners not fitting and refinement may need to be done.

  • Each set of aligners should be work 20-22 hours a day to be considered compliant.

  • If life events happen and if you are wearing aligners less than 20 hours per day, it is best to add on an additional day longer for each set. (Example: 1 set to be worn 10 full days if wearing them 20-22 hours a day, but 11-12 days for someone wearing them 16-18 hours a day)

  • If for any reason you lose 1 set of aligners, it is important you proceed to a new current set of aligners ASAP or give us a call directly.

  • I understand to never wrap my Aligners in a paper napkin as it may get mistaken as trash and to keep them in a case instead.

  • Aligners must be removed when eating or drinking.

  • Cold and lukewarm water are the only things I may drink with my aligners on.

  • If at any point I am incompliant and not wearing my aligners 20-22 hours a day, it may result in multiple refinements, each subjected to additional fees per scan if needed (3 free refinements included).

  • If I notice my aligners are not fitting properly, I will immediately call the office to advise them.

  • At the end of my Orthodontic Treatment, 1 set of retainers will be included. Additional retainers may be purchased at an additional rate as a set of 4 upper and 4 lowers.

  • My retainer is to be worn 5-7 days out of the week on an average time span of 7-12 hours per night for the rest of my life to prevent teeth from shifting/moving.

  • If I lose or misplace my retainer, it's important that I get a new one made ASAP to prevent teeth from shifting.

* Please be advised Tooth-colored attachments will be placed on the teeth and possible fine smoothing in between the teeth (IPR) to help get the ideal treatment plan. All attachment will be removed when completing clear aligner treatment.