Invisalign Informed Consent FormInvisalign Informed Consent FormInvisalign Informed Consent Form
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INVISALIGN INFORMED CONSENT AND AGREEMENT FOR THE INVISALIGN PATIENT

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Notice to treating office: This form is to be signed by your Invisalign®
patients prior to treatment and kept for your records and should not be
sent to Align Technology, Inc.

PATIENT’S INFORMED CONSENT AND
AGREEMENT REGARDING INVISALIGN®
ORTHODONTIC TREATMENT
Your doctor has recommended the Invisalign® system for your

orthodontic movements. Patients may require additional
impressions and/or refinement aligners after the initial series of
aligners.

orthodontic treatment. Although orthodontic treatment can

BENEFITS

lead to a healthier and more attractive smile, you should also

• Invisalign® aligners offer an esthetic alternative to conventional

be aware that any orthodontic treatment (including orthodontic
treatment with Invisalign aligners) has limitations and potential
risks that you should consider before undergoing treatment.
DEVICE DESCRIPTION
Invisalign® aligners, developed by Align Technology, I