Invisalign Release Form
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Web release of patient by current treating provider. Please transfer the patient listed above out of my invisalign doctor site including the patient’s clincheck ® files. This authorization shall be valid three years from its date. Web release and waiver (premature removal of appliances) i hereby certify, on behalf of (myself) (my child), and all those who may now or.
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1 of 3 patient’s informed consent and. The first section is applicable for those receiving invisalign full. This authorization shall be valid three years from its date. A photocopy of this release shall be considered as effective and valid as the original. 4 invis is straightening & whitening in one.
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I Have Read And Understand The Contents Of This Release.
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