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Patient Registration

Please provide your details below and accept our terms and conditions:

I understand the risks of Denturly treatment include, but are not limited to, potential loss of bone or gum tissue, loosening of teeth, shortening of tooth roots, and jaw dysfunction or discomfort. Chronic usage of anti-inflammatory medications, aspirin, estrogens, or calcitoninmay slow or limit tooth movement. I hereby certify that I have been examined by a licensed dentist within the past year, have received a cleaning in the last six months, and do not have any of the above conditions or any other condition that may affect my medical or dental health or ability to be treated properly. Additionally, I understand that I have been advised by Denturly, that my best health interest would be served by having an orthodontic consultation by a licensed dental professional before purchasing any Denturly Denture. I certify that I am over 18 years of age In the event that I do not proceed with treatment due to a contraindication or treatment or any other medical reason, I will seek care and follow up with my regular dental professional. I have read and understand Denturly’s Terms and Conditions and agree to be bound by them. I agree to enter this treatment plan and will not hold Denturly, any supplier, or any member of staff responsible for my medical or dental health.

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