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Consent Treatment with the Inman Aligner has proven to be very successful but with every form of orthodontics there are certain risks involved which should be seriously considered before undertaking treatment. Please read the below statements and if you understand them and are fully aware of the risks please sign and date at the end. I understand that the result has been predicted before treatment has begun therefore the outcome may not exactly replicate the result discussed beforehand if the advised treatment plan hasnt been followed correctly. I understand that a lack of compliancy poor oral hygiene and missed appointments lengthen treatment time and these are all things I can prevent from happening. 100 cooperation is very important. I understand that the Inman Aligner must be worn full time for at least 16-20 hours a day apart from when eating or brushing teeth. Remember that the longer you wear the Inman Aligner the quicker the results. I understand that teeth have a tendency to return to their original position after treatment relapse and that at the end of treatment retention is required for life in order to preventthis. I accept the treatment plan recommended by Nimrodental and explained to me by my dental practitioner. Name............................................ Date