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Early Orthodontic Termination Form.pdf DOWNLOAD HERE Release of Liability Early Removal of Orthodontic appliances http://www.drehsani.com/Portals/0/Early×20Termination.pdf perspective and must protect
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How to fill out early orthodontic termination form

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How to fill out early orthodontic termination form

01
First, obtain the early orthodontic termination form from your orthodontist.
02
Carefully read and understand the instructions provided on the form.
03
Fill in your personal information accurately, including your name, date of birth, and contact details.
04
Specify the reason for early termination of orthodontic treatment in the designated section on the form.
05
If there are any specific instructions provided by your orthodontist, make sure to follow them and mention them on the form as required.
06
Review the completed form to ensure all sections are filled correctly and legibly.
07
Sign and date the form in the designated areas.
08
Submit the form to your orthodontist as per their instructions. It may be required to be hand-delivered or sent via mail or email.
09
Keep a copy of the filled-out form for your records.

Who needs early orthodontic termination form?

01
Individuals who wish to terminate their orthodontic treatment ahead of schedule may need to fill out the early orthodontic termination form.
02
Patients who have experienced changes in their dental health condition or personal circumstances that necessitate the discontinuation of orthodontic treatment may require this form.
03
Parents or guardians of underage patients who decide to terminate orthodontic treatment for their child may also be required to fill out this form.
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The early orthodontic termination form is a document used to terminate orthodontic treatment before its expected completion date.
The orthodontist or the patient's guardian is required to file the early orthodontic termination form.
The early orthodontic termination form must be filled out with the patient's information, reason for termination, and any additional comments.
The purpose of the early orthodontic termination form is to officially end orthodontic treatment and document the reason for termination.
The early orthodontic termination form must include the patient's name, date of birth, reason for termination, and signature of the orthodontist or guardian.
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