Whitening for Life!

Who is it for?

Patients who maintain regular dental appointments with our office are eligible to participate in this program. Must be at least 16 years of age.

How it works...

We want you to love your smile. Many people would love a brighter smile, but don't follow through with making their smile stand out. By regularly visiting our office, you are telling us you are committed to your oral health.

Upon completion of a New Patient Exam and cleaning, a custom whitening tray will be made* and you will receive 2 syringes of professional whitening gel. At every scheduled 6-month cleaning and check-up, you will receive 2 additional syringes of professional whitening gel.

If you are an existing patient, just let us know you want to participate in our Whitening for Life program.

It's that simple. We want to say thank you for trusting us with your beautiful smile by making it bright!

What does it include?

“Whitening for Life” is available at your Patient Exam and includes:

• A set of custom whitening trays
• 2 syringes of whitening gel
• 2 additional syringes of whitening gel at every 6-month cleaning and check-up appointment.
• If you run out of whitening gel before your next scheduled appointment, you can purchase more gel at our office for $20 per syringe.

What you need to do...

In order to participate with this program, you must maintain the 6-month appointment or reschedule a 6-month appointment with 2 weeks of a missed appointment. Failure to maintain regular appointments will result in removal from the program. If you have been removed from the program, you can re-enroll in this program by rescheduling an appointment and paying a $50 reinstatement fee.

IMPORTANT

Certain dental conditions may disqualify you from being offered this program. At the discretion of the Doctor, you may be recommended to complete certain dental procedures prior to initiating a whitening program. The Doctor and/or staff will clearly explain any disqualifying conditions you may have, and how to treat those conditions to enable participation.

Such conditions may include, but are not limited to:

• Periodontal Disease
• Existing Dental Work
• Cavities
• Existing Health Conditions

Disclaimer:

Champlain Smiles, its Doctors and Staff have the right to refuse this offer if necessary based upon patient health conditions, misuse, abuse, or any other factors deemed necessary to void offer. Patients must maintain their teeth, gums and oral cavity at Champlain Smiles to receive professional whitening.

1. Patient must maintain minimum continued care as treatment planned and appointed by Champlain Smiles, its Doctors and Staff.
2. Patient must maintain continued hygiene care (typically six month hygiene appointments*).
3. Patient must comply with all Champlain Smiles policies regarding payment and broken appointments
4. Patient will receive a maximum of two whitening solution refills at each re-care appointment.
5. Lost or damaged applicator trays will be replaced at cost to patient ($50)

* Whitening tray impressions will be taken at the initial appointment and be should available within 1 week.

* Diagnosis of Periodontal Disease or other conditions may require more frequent visits to Champlain Smiles.