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This application is made between YOU (the applicant) and the Charles Dental Group. The Charles Dental Group has the right to void, deny, terminate or refuse service to any individual and/or application. Review the following statements and verify all "true" before proceeding. If one or more of the following statments are not true, please exit this application process.
- It is TRUE - I am a Legal U.S. Citizen
- It is TRUE - I am between the ages of 13 and 19
- It is TRUE - If I am under the age of 18 I am being accompanied by a parent at this time
- It is TRUE - I am not related to any employee of the Charles Dental Group
- It is TRUE - I understand I am applying for an Invisalign Teen Treatment
- It is TRUE - I understand there is NO cash value to this offer
- It is TRUE - I'm excited and ready to continue!!!!
* All fields below are required.
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