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AT-HOME IMPRESSION

ASSUMPTION OF RISK & RELEASE

AT-HOME IMPRESSION

ASSUMPTION OF RISK & RELEASE

PLEASE READ CAREFULLY BEFORE TAKING YOUR DENTAL IMPRESSION.

Taking your own dental impression involves placing impression material and a dental tray over and around your teeth and allowing the material to set before removing the tray.

Although most impressions can be completed without incident when instructions are properly followed, taking an impression involves risks.

By choosing to use a Vision Dental Lab at-home impression kit, you acknowledge and agree to the following.

1. I UNDERSTAND THE RISKS

I understand that taking my own dental impression may involve risks including, but not limited to:

  • discomfort or pressure;

  • gagging or nausea;

  • gum or soft-tissue irritation;

  • temporary sensitivity;

  • impression material becoming difficult to remove;

  • aggravation of an existing or previously unknown dental condition;

  • loosening, dislodging, breaking, or damaging a filling;

  • loosening, dislodging, breaking, or damaging a crown;

  • damage to a bridge, veneer, implant restoration, temporary restoration, orthodontic appliance, or other dental work;

  • injury to a loose, cracked, weakened, decayed, damaged, or otherwise compromised tooth;

  • allergic reaction, sensitivity, or irritation associated with an impression-kit component; and

  • an inaccurate or unusable impression resulting from improper placement, movement, timing, removal, or failure to follow instructions.

I understand that this list identifies foreseeable categories of risk but cannot identify every possible circumstance.

2. I WILL NOT FORCE THE IMPRESSION

I UNDERSTAND THAT I SHOULD NEVER FORCE AN IMPRESSION TRAY ONTO OR OFF MY TEETH.

If the tray becomes unusually difficult or painful to remove, I will stop attempting to forcefully remove it and seek appropriate assistance from a dental professional.

3. EXISTING DENTAL WORK

I understand that crowns, bridges, veneers, fillings, implants, temporary restorations, orthodontic appliances, damaged teeth, loose teeth, and other dental work may increase the risks associated with taking an impression.

If I know or reasonably suspect that I have loose dental work, a loose tooth, a temporary restoration, significant dental pain, infection, or another condition that could make taking an impression unsafe, I understand that I should consult a licensed dental professional before proceeding.

4. VISION DENTAL LAB HAS NOT EXAMINED ME

I understand that purchasing an at-home impression kit does not constitute an in-person dental examination.

Vision Dental Lab has not physically examined my teeth or gums through the online ordering process and may therefore be unaware of conditions that could affect the safety of taking an impression.

I understand that an at-home impression kit is not a replacement for professional dental care.

5. MY RESPONSIBILITY

I agree to:

  • read the instructions completely before beginning;

  • follow all supplied instructions and warnings;

  • provide requested information accurately;

  • disclose requested known allergies or sensitivities;

  • discontinue the process if I experience significant pain or believe continuing could cause injury;

  • refrain from using excessive force; and

  • obtain professional dental assistance when appropriate.

6. VOLUNTARY ASSUMPTION OF RISK

I KNOWINGLY AND VOLUNTARILY ASSUME THE ORDINARY AND REASONABLY FORESEEABLE RISKS INHERENT IN TAKING MY OWN DENTAL IMPRESSION, INCLUDING THE SPECIFIC RISKS DESCRIBED ABOVE.

I understand that injuries or damage may occur even when instructions are followed.

I voluntarily choose to proceed with an at-home impression after being informed of these risks.

7. RELEASE REGARDING THE CUSTOMER-CONTROLLED IMPRESSION PROCESS

TO THE FULLEST EXTENT PERMITTED BY IDAHO LAW, I release and hold harmless Vision Dental Lab and its owners, employees, agents, and representatives from claims for injury or property damage resulting from the ordinary and inherent risks of my customer-administered impression process that I have knowingly and voluntarily assumed above, including risks arising from:

  • my placement or removal of the impression tray;

  • my use of excessive force;

  • my failure to follow supplied instructions or warnings;

  • inaccurate or incomplete information supplied by me;

  • existing dental conditions or dental work unknown to Vision Dental Lab;

  • an undisclosed allergy or sensitivity; or

  • my misuse or unauthorized modification of the impression kit.

THIS RELEASE IS NOT INTENDED TO RELEASE LIABILITY THAT CANNOT LAWFULLY BE RELEASED UNDER IDAHO LAW.

8. MATERIAL SENSITIVITY

I understand that individual reactions to dental or impression materials are possible.

I agree to disclose requested known allergies or sensitivities before proceeding.

I voluntarily assume the risk of an individual sensitivity or allergic response that was unknown to Vision Dental Lab and could not reasonably have been anticipated from the information I provided or applicable manufacturer information.

9. NO GUARANTEE

I understand that completing an impression does not guarantee that it will be suitable for manufacturing.

Vision Dental Lab may reject an impression and require another impression if the submitted impression is incomplete, distorted, damaged, inaccurate, or otherwise unsuitable for fabrication.

10. ACKNOWLEDGMENT

BY CHECKING THE BOX BELOW, I CONFIRM THAT:

  • I have read this Assumption of Risk & Release;

  • I understand the risks described above;

  • I have had an opportunity to decide whether I wish to proceed;

  • I understand that Vision Dental Lab has not performed an in-person dental examination through this process;

  • I understand that I may consult a licensed dental professional before proceeding;

  • I voluntarily choose to use the at-home impression kit; and

  • I agree to this Assumption of Risk & Release.

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