This includes:

• All diagnostic records and x-rays
  
• Orthodontic treatment with standard metal braces typically used in our practice, metal wires and any necessary appliances. 
• One set of upper and lower clear Essix retainers.
• All appointments from braces application to removal.
• Retainer monitoring appointments for up to 9 months following removal of braces.

This does not include:

• Invisalign or any other clear aligners
  
• Rivera retainers
• Replacement retainers
• Ceramic brackets
• Wild Smiles brackets
• Phase I early treatment
• Orthognathic surgical cases
• Oral surgery or extractions
• Dental cleanings and hygiene appointments
• Any other dental work outside of standard orthodontics such as fillings, bondings, crowns, veneers, root canals, implants, bleaching or any services rendered by providers outside of our practice.
• Further orthodontic re-treatment due to relapse for any reason

• The end user of this certificate must be a new patient and not a patient of record in our practice.
  
• No insurance benefits can be used in conjunction with this certificate.
• No reimbursements will be made to the bearer of this certificate from the practice or the insurance company.  
• This certificate is issued without prior knowledge of the complexity of the end user's case.  No refunds will be issued if the case turns out to be a simple one.  Conversely, no upcharges will be made if the case turns out to be a complex one. 
• We agree to treat the bearer of this certificate to the best of our abilities and expect full compliance and cooperation with all instructions and oral hygiene.  Successful orthodontics treatment requires exemplary patient compliance.  Patient is expected to comply with all office policies and procedures.
• We reserve the right to terminate treatment if the end user of this certificate is not compliant with instructions needed to obtain a favorable outcome or if oral hygiene levels are poor enough that the teeth start to become stained or develop cavities.  No refunds will be issued if treatment is terminated prior to completion for any reason.  
• If the end user of this certificate moves away during treatment and needs to transfer care to another orthodontist, no refunds or payments to the new orthodontist will be issued for any reason.
• Treatment may only be rendered at Medfield office location. It is not valid at other locations that our doctors may work.