RETENTION CONTRACT 
Once the fixed appliances have been removed, it is particularly important to contact your family dentist for a check-up. I urge you to do so as soon as possible. 
RETENTION INCLUDES: Appointments in approximately 1, 3, 6 and 12 months depending on the malocclusion. 
After 24 months, you will be placed on Demand Recall, which means that you will need to call our office if a retainer adjustment is necessary. (There will be a charge per visit.) 
While maintaining your retention, PLEASE CONTACT OUR OFFICE IMMEDIATELY IF:

1. There is any change in the fit of your retainers.

2. Your retainers are lost or broken.
 
Please bring all your retainers to every appointment. If the retainers are worn properly, they will fit and the teeth will not move. Research has shown, LIFETIME retention is the only way orthodontically treated teeth remain stable. If the patient has not maintained retention, any further treatment rendered will be subject to the appropriate charge. 
RETAINER REPLACEMENT: Your original (1) set of retainers is included as part of your fee. There will be a charge for any replacements. 
Thank you for choosing our office, we hope you are pleased with the orthodontic result. 
I have read the enclosed retention information, and I understand how to maintain my orthodontic correction. 
Patient:   Date:
Responsible Party:   Date: