Patient_______________________________________    Date__________________


You have been an Invisalign patient for awhile and we respect that you have made a decision to not regularly come in for further appointments. We understand when this occurs for patients.


You can choose to not go further with your Invisalign treatment. We would be happy to make you new retainers at your current bite and alignment positions of your teeth and smile. This is included and provided at no additional fee from our office for this first set of retainers.


Retainers can be provided for you. Simply contact our office within the next 90 days for an appointment to receive these custom appliances. Thereafter, you would not be making regular appointments unless some concern or need arises. Any future replacement retainers and office imaging or visits would have a fee, according to what may be needed at the time. We are here to provide care.


The refinement date for your Invisalign treatment, related laboratory and virtual site fees would be re-evaluated and a fee charged in the future if and when you decide to have further Invisalign procedures. If you stay in retainers, then this would not apply.


Your Invisalign refinements expiration date was _______________________. This date is established by Align Technology Co., the makers of Invisalign. This completion date builds in 6-12 months of extra time so that each patient can complete the straightening process before this expiration date occurs. Most Invisalign patients are able to complete their Invisaligners series in the extra time allotted in the overall treatment time and plan.


We hope and trust that these explanations are helpful. If you have further questions, please ask. Let us know your decision. Thank you.


Grummons Elite Invisalign Team

Home of the Grummons Signature Smile


Duane Grummons, DDS, MSD                                   Rachel Lopez

Board Certified Orthodontist                                             Invisalign Manager


9425 N. Nevada, Suite 100

Spokane, WA 99218

PH: 509.23BRACE

FX: 509.328.5949

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