Orthodontic Release Form

Orthodontic Release Form - Orthodontic treatment requires the full cooperation of the. I, _____________________________ hereby request to discontinue my/my child’s orthodontic treatment, and remove all orthodontic appliances, even. Patient uncooperative or noncompliant and discontinuation of treatment is in his/her best interest. I further acknowledge that said doctor has advised me against removal of said appliances at this time,.

I, _____________________________ hereby request to discontinue my/my child’s orthodontic treatment, and remove all orthodontic appliances, even. I further acknowledge that said doctor has advised me against removal of said appliances at this time,. Patient uncooperative or noncompliant and discontinuation of treatment is in his/her best interest. Orthodontic treatment requires the full cooperation of the.

I, _____________________________ hereby request to discontinue my/my child’s orthodontic treatment, and remove all orthodontic appliances, even. Patient uncooperative or noncompliant and discontinuation of treatment is in his/her best interest. I further acknowledge that said doctor has advised me against removal of said appliances at this time,. Orthodontic treatment requires the full cooperation of the.

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Orthodontic Treatment Requires The Full Cooperation Of The.

I further acknowledge that said doctor has advised me against removal of said appliances at this time,. I, _____________________________ hereby request to discontinue my/my child’s orthodontic treatment, and remove all orthodontic appliances, even. Patient uncooperative or noncompliant and discontinuation of treatment is in his/her best interest.

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