Cosmetic Tooth Gem/Jewelry Waiver of Liability

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Tooth Gem/Jewels Introduction
Tooth Jewels are simple, subtle and shimmering! Swarovski® is considered to produce the finest precision-cut crystals in the world. Their crystals are polished to the highest standards of quality and sparkle like diamonds. Our tooth jewelry is made by 100% Authentic Swarovski Crystals that are small in diameter and applied to the tooth using safe dental materials. You should continue routine dental care & treatment with your Dentist.

Tooth Gem/Jewels Facts
Our application requires no drilling and no holes. It is completely painless, will not harm the tooth, and can be easily removed. It is perfect for those who want a bit of glamour and fun! They are truly chic, yet elegant. We also offer gold and diamond jewels as well as different shapes, colors & sizes! All our gems come with a 7 day Warranty.

• It is non-invasive, painless., & Stain resistant, and requires healthy TEETH AND GUMS.

• Requires no extra maintenance, & doesn't obstruct regular brushing or dental visits.

• Can be removed or replaced anytime (at your dentist) has no effect on the tooth enamel once the jewel is removed or replaced.

• Involves a procedure that only takes about 15 minutes and is 100% reversible.

Our tooth jewels can be a temporary enhancement which will last up to 1 month & beyond or may stay on until you decide to have it removed. (We do not remove them)

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Authorization

I authorize my payment(s) without dispute to my card & agree the charge is valid to be made to Simply Bright Smiles LLC & I understand this service is NON-REFUNDABLE. I also authorize use of any before & after photos/videos that may be taken to be used for advertising purposes & Security Reasons with Simply Bright Smiles LLC and Simply Bright Smiles Whitening & Beauty Bar.

By typing my Full Name below, I'm signing this waiver with my electronic signature.

I HAVE READ THIS DOCUMENT AND UNDERSTAND ITS CONTENTS. I FURTHER UNDERSTAND AND AGREE THAT BY SIGNING THIS RELEASE OF LIABILITY, I VOLUNTARILY SURRENDER CERTAIN RIGHTS. SIMPLY BRIGHT SMILES LLC, OWNERS, AND EMPLOYEES ARE NOT RESPONSIBLE OR HELD LIABLE FOR ANY DAMAGE CAUSED BY TEETH WHITENING TREATMENT AND/OR TOOTH GEM APPLICATION.

Type Gold Charm number you would like (Charm is ordered based on what you select at booking and cannot be changed) Type N/A if you are not Scheduling for Gold Tooth Charms *

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