Clinic Terms

CONSENT FOR ASSESSMENT BY A DENTIST

I confirm that I understand I am visiting a dentist who is working solely to assess whether I am suitable for clear aligners and to examine my teeth. I am happy to visit this dentist and confirm that I consent to the dentist examining my suitability for clear aligners, which I wish to undertake. If suitable, the dentist will take x-rays and a dental exam of the teeth to be moved. This dentist is working in his/her independent capacity to examine my teeth.

I consent that Tooth Fairy will receive my medical records from this assessment and any future appointments, including, but not be limited to, radiographs (x-rays), reports, charts, medical history, photographs, findings, models, impressions of teeth, or intra-oral scans, prescriptions, diagnosis, medical testing, test results, billing, and other treatment records that are assessed by the dentist, (“Medical Records”) to the extent necessary for treatment, customer service, and billing. I will not, nor shall anyone on my behalf, seek legal, equitable, or monetary damages or remedies for such disclosure. I acknowledge that the use of my Medical Records is without compensation, and I, nor shall anyone on my behalf, have any right of approval, claim of compensation, or seek or obtain legal, equitable, or monetary damages or remedies arising out of any use that complies with the terms of this Consent.

48 HOUR CANCELLATION POLICY FOR APPOINTMENTS

Your appointments are very important to us. Your appointment is reserved especially for you and, while we understand that sometimes schedule adjustments are necessary, we respectfully request at least 48 hours’ notice for cancellations. Please understand that when you forget or cancel your appointment without giving enough notice, we miss the opportunity to fill that appointment time, and patients on our waiting list miss the opportunity to receive services.

CANCELLATION FEES

A cancellation fee will apply if you fail to give at least 48 hours’ notice that you cannot make your appointment or do not show up for the appointment. The deposit paid upfront will be kept, and you will be asked to make a deposit when rebooking the appointment.  Patients who consistently cancel at short notice may be asked to pay the full fee of their appointment upfront. The cancellation policy gives us the time to inform our patients on our waiting list of any availability and keeps our clinician’s schedules filled. We aim to provide you with an excellent level of service, and our policies help us achieve this.

Thank you for viewing and supporting our policy criteria.

If i have any further questions about my data I can email office@toothfairyapp.co.uk

Read the full Privacy Policy Here