Teeth Whitening Consent Form

Clear consent is what turns a happy whitening client into one who stays happy, because it sets expectations before the gel goes on. This form records it in plain language. It captures the client’s details and date of birth, space to note any dental work or sensitivity, and then the confirmations that matter. Those confirmations are honest about the realities: that results vary and depend on the cause of staining, that existing crowns, veneers and fillings won’t change colour and may need replacing to match, that temporary sensitivity or gum irritation can occur, and that whitening isn’t permanent and is maintained with good care and top-ups. A disclosure line, an over-18 confirmation and a signature complete a dated record that protects you and keeps expectations grounded. Have every client sign it before treatment. It’s free, brand-styled, and turns the expectations conversation into a documented, reassuring step.