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Safe · Professional · Radiant Results
Please read the information below and complete your details before proceeding to payment. This helps us ensure your treatment is safe and suitable for you.
Tick all that apply and add details where needed.
Expected resultsWhitening may lighten the colour of natural teeth.
Results varyResults vary between people and cannot be guaranteed.
LongevityThe result is not permanent and may fade over time.
Crowns, veneers, fillings, bonding, dentures, bridges, and implants will not whiten.
Some deeper or internal stains may respond unevenly or remain visible.
Teeth whitening is not suitable for you if you are:
I have read and understood the information in this form. The expected benefits, important risks, limitations, aftercare, costs, and alternatives have been explained to me. I have had the opportunity to ask questions and understand the answers. I confirm that the information I have provided is accurate. I understand that results cannot be guaranteed and that I may withdraw my consent before or during treatment. I voluntarily agree to proceed.
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