Virtuosum Orthodontics Treatment Agreement Information

Before starting your orthodontic treatment with Virtuosum Orthodontics, please take a moment to read the following information. It is important to ensure that all financial matters are taken care of and necessary documents are signed before treatment commences. Here are some key points that you should keep in mind:

• All documentation must be signed and payment for treatment must be arranged before treatment is commenced or appliances are approved for manufacture.
• All payment plans are set up through a third party called DentiCare. This allows us to concentrate on the most important part of your/your child’s orthodontic treatment while DentiCare takes care of the financials. Please ensure you read through the DentiCare Service Agreement.

DentiCare

To qualify for DentiCare you must meet the following requirements:

1. You are an Australian Citizen (Australian Resident status does not qualify – if you are a permanent resident, please inform staff as alternative options are available).
2. You are 18 years or older.
3. You are gainfully employed.
4. You are currently not bankrupt or subject to any bankruptcy and/or debt agreement If you have any further questions regarding DentiCare please call them directly on 1300 633 472.

• Payment plan periods are separate from the orthodontic treatment time. You may choose to set up a payment plan over a longer period and continue paying once your treatment is complete. Alternatively, you may choose to complete payments earlier but still be in the process of treatment.
• Please refer to your fee agreement for what is included in your investment in a beautiful smile.
• If you have a private health fund, please discuss your claim options with them directly before the commencement of treatment, as all health funds work very differently. Virtuosum Orthodontics can provide receipts for payments made directly to us, as well as a Treatment Plan letter to assist in claiming. DentiCare can also provide you with an Health Fund Statement for claiming purposes. Any questions about your payment plan can be directed to DentiCare on 1300 633 472.
• Active treatment time is individual and can vary greatly depending on the complexity of treatment required. At times, treatment may take less time than predicted, while at other times, it may take longer than predicted due to individual biological variations. The treatment fee is fixed in either case. Please note that no treatment method can be guaranteed to finish within a specified time period.

Cancellation of Treatment

If you have signed up for orthodontic treatment, paid the deposit and signed all documentation, but choose to cancel treatment, please take note of the following:

• Fees will apply for cancellations.
• Cancellations after the manufacturing of appliances will result in fees, which may lead to the forfeiture of the deposit.
• If you have commenced treatment and wish to finish treatment early for any reason, the cost for the treatment up until that point will be determined by Virtuosum Orthodontics.

Duration of Orthodontic Treatment

• The duration of orthodontic treatment varies for each individual case. Although we provide patients with an estimate of their treatment time, we cannot predict the exact length of treatment.
• Individuals vary considerably in their response to orthodontic forces so that treatment time may be more or less than our estimate. Our general intention is to have the treatment move along in a fashion consistent with tissue heath, minimal discomfort and long-term stability.
• The lack of patient cooperation in the form of poor compliance, such as failure to wear aligners or elastics, unwarranted breakages, missed appointments, and failure to wear elastics as directed, can result in extended treatment time and fees.

Services Performed by Other Practitioners

• Any procedures performed by other health care providers are not included in our treatment fees (e.g.: Fillings, Cleaning, General Dental Examinations, Extractions, Whitening, Oral Surgical Procedures etc.)
• Additional charges will be levied for lost or broken appliances and for poor compliance that leads to increased treatment time.

Change of Treatment Plan

• If a patient wishes to change their treatment plan, such as changing from clear aligner treatment to braces, an additional treatment fee will be incurred.
• If the treatment plan needs to be changed due to poor compliance, missed appointments, unforeseen biological factors such as atypical tooth formation and disproportionate jaw growth, poor oral hygiene and growth response, then additional fees may be required. The patient will be kept informed.

Patient / Account Holder Consent

By signing below, I consent that I understand and agree to the terms and conditions as outlined above.