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SmileLabs Customer Purchase Agreement and Waiver
Informed Consent and Acknowledgement
The client understands and assumes the risks of the use and application of teeth whitening products. The SmileLabs photosensitive peroxide-based teeth whitening gel is applied to your teeth and is activated by our accelerator light to speed up the whitening process. During your treatment, you may experience a slight tingling or fizzing sensation which is normal. You should not experience any pain. If you do experience pain during use of this product, immediately notify the staff and discontinue use. People with overall healthy gums and teeth, whose teeth are stained or which have yellowed over time, often have the most dramatic results. Your oral hygiene, lifestyle, and genetics determine the current shade of your teeth. SmileLabs teeth whitening gel removes most stains and visibly brightens the teeth, but it will not result in a different shade from your natural genetically-determined color. It will not change the color or whiten fluorosis or tetracycline stained teeth, nor will it change the color of crowned, capped, veneered, or bonded teeth. On rare occasions, some clients report little or no whitening results.
Each person’s teeth react differently to photosensitive peroxide-based teeth whitening gel, and individual results may vary. The staff applying your gel is not a dentist or hygienist and will not answer any dental or medical questions. Those questions should be referred to your dentist or physician. You, as a client, are hereby informed that there are some risks regarding the misuse, misapplication, and/or mishandling of peroxide-based teeth whitening gel. These could cause serious skin or gingival tissue irritation which might be described as burning, bleeding, or red and/or white blanching. By entering your name on the Booking Form and checking the box therein, you hereby assume the risk that you may experience these adverse effects as a result of applying teeth whitening products to your teeth.
Teeth whitening products are not suitable for anyone who is currently pregnant, have currently unfilled holes/cavities in their teeth, have had oral surgery within the last 90 days, or currently have untreated gingivitis or gum diseases. Furthermore, these products are not suitable for persons taking any medication that makes them sensitive to light, have oral piercings that cannot be removed that could cause sensitivity, are under the age of 14, or have been advised against using teeth whitening products by their dentist. Please notify the staff of any of the aforementioned items which could disqualify you from using SmileLabs products.
Customer Release and Liability Wavier
I, the client, on the one hand and the Authorized SmileLabs Dealer and/or Staff, on the other hand (collectively called the “Released Parties”) enter this Customer Purchase Agreement. The Authorized SmileLabs Dealer and Staff sells SmileLabs LLC and/or SL Chandler, LLC cosmetic teeth whitening products. As a material inducement to the Released Parties, I, the client, do hereby waive and release, indemnify, hold harmless, and forever discharge the Released Parties and its agents, employees, affiliates, successors, members, managers, etc. and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages, and liabilities of every kind and nature, whether known or unknown, in law and equity, that I ever had or may have, arising from or in any way related to the products and/or services being provided to me by the Tallahassee SmileLabs Authorized Dealer or Staff. By this waiver and release, I assume and risk and take full responsibility and waive any claims of personal injury, death, or damage to personal property associated with the teeth whitening products and teeth whitening services provided by the Released Parties. This Wavier and Release contains the entire agreement between the Released Parties and myself, and supersedes any prior written or oral agreements concerning the subject matter of this Waiver and Release. The provisions of this Waiver and Release will continue in full force and effect even after the termination of the services being provided to me whether by agreement, or by operation of law, or otherwise.
I understand the Authorized Dealer only sells various products of SmileLabs LLC / SL Chandler, LLC and nothing shall be construed to mean the Authorized Dealer or Staff are partners, joint ventures, nor representatives of SmileLabs LLC / SL Chandler, LLC. This agreement is governed by the laws of the State of Arizona, Maricopa County. I agree that any and all litigation arising from or related to this Agreement must be pursued in Maricopa County, which will be the sole and exclusive venue for any such action. I have read the above and certify that, I, the Releasor, have healthy teeth and gums and know of no reason why I should not utilize SmileLabs products. I, the Releasor, understand the Released Parties are not dental professionals. I understand the Released Parties do not guarantee my results or how long my teeth will maintain their new shade of white. If I pay with a credit card, I authorize the Released Parties to charge my card. All sales and are final and there are no refunds. I understand the use of the products may cause my teeth to remain white for a longer period of times. I have read this document and fully understand it. I have been given the opportunity to ask questions regarding SmileLabs products and I am satisfied that I have been informed of, and understand, SmileLabs products. I confirm that by signing this Wavier and Release, I have given up considerable future legal rights. I have signed the Agreement freely, without indictment, promise, or guarantee being communicated to me. My typed name on the Booking Form is proof of my intention to execute a complete and unconditional waiver and release of all liability to the full extent of the law. I am 18 years of age or older and mentally competent to enter into this Wavier and Release.