Whitening for Life Program


Lima, New Bremen, and Spencerville Dental Associates’ Free Whitening for Life Program is for patients who are already taking their dental health seriously and as an incentive for those who need a little help keeping up with their dental care. We hope you enjoy this program and encourage you to invite family and friends to take part in our Free Whitening for Life Program.

This privilege does require that you follow a few rules. Please read through them carefully, review the policy and sign below. Your signature acknowledges receipt, understanding and compliance of the policy. While our Free Whitening for Life Program is a gift from us to you, we insist that all rules are followed in order to receive this benefit.

ACTIVATION RULES:

  1. Must be 18 years of age
  2. Must complete hygiene cleaning, x-rays, doctor’s exam, and schedule your next 6 month appointment
  3. Must comply with minimum required dental treatment, if any, as planned by the doctor. (minimum care can include fillings, extractions, root canals, and crowns)
  4. After all necessary dental treatment is complete; impressions will be taken for professional whitening trays. Cost of the trays is $199. Trays will be ready within one week along with proper instructions for use.
  5. Must keep all of your scheduled appointments. Any cancellations will be done with at least 48 hours in advance and original appointment rescheduled within the next two (2) weeks
  6. Must not have any outstanding bills with our dental office

LIFETIME MAINTENANCE RULES:

  1. Must maintain minimum continued care as treatment planned and pointed by Lima, New Bremen, and Spencerville Dental Associates
  2. Must maintain continued hygiene care (6 month hygiene appointments)
  3. Must comply with all policies regarding payment and broken appointments
  4. Must keep all scheduled appointments (48 hour cancellation notice)
  5. One whitening gel refill will be given at each continued hygiene appointment up to twice annually
  6. Lost or destroyed trays will be replaced at a cost to the patient
  7. If trays no longer fit due to treatment completed Lima, New Bremen, and Spencerville Dental Associates will replace that tray free of charge
  8. Should any of the rules fail to be met you will immediately be disqualified from the program and provided the opportunity to re-enroll for a $30 re-activation fee

Click here to view or download the Whitening for Life Program Agreement

 

Disclaimer: Lima, New Bremen and Spencerville Dental Associates, its doctors, and staff have the right to refuse offer if deemed necessary based on patient health conditions, misuse, abuse or any other factor deemed necessary to void offer. Minimum gum and teeth health are required to receive professional whitening.


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