CADIS MEMBERSHIP PLAN - Terms and Conditions of Plans

CADIS Plan Membership is on a 12 month contract, this includes if you pay annually or you pay
monthly – paying monthly or annually will be a rolling contract. For example, if you cancel in month
7 there will still be charges for months 8, 9, 10, 11, and 12. This will be effective for both annual
and pay monthly patients.

Examinations will be with the dentist, twice per year

Scale and Polish may with the dentist or hygienist if hygienist is available.

Small X-rays are for diagnostic purposes

Assessment of emergency and dental pain with any temporary treatment required – we pride
ourselves on being able to book an appointment with the dentist at the earliest convenience. In this
appointment we may provide temporary treatment for example a temporary filling. Any subsequent
treatment will be discussed with you and at what cost to you

Treatment Planning is vital to any treatments we offer you

Dependents under the age of sixteen, they are entitled to free checkups on a six monthly basis as
well as preventative advice and education. Should they require dental treatment, this can be
provided at a considerably subsidised rate

Once dependent reaches their 16th birthday, they will be automatically be taken off their Parents
Plan. They will be encouraged to maintain their oral health by joining one of our membership plans.

Discount on all dental treatment (excluding Facial Aesthetics, Dental Implants and Teeth Whitening)
will be adhered too. This is a 20% reduction on prices we would charge a pay as you go patient.
Any Facial Aesthetic, Dental Implants and Teeth Whitening will be charged at a standard rate.

Large X-rays are included in our Platinum Plan; these are often needed for maintenance
programmes, larger treatment plans such as extensive restorative work and with dental implant
work. If you need a large x-ray the dentist will explain to you why this is needed and book you in
for this. If you are a pay as you go patient or a Gold Plan Member there will be a charge for the Xray of £65.

Whitening for Life – once the dentist has seen you at your twice annually checkups. A tube of
whitening gel will be given to you. These will be given twice annually. Any additional gels may be
purchased at Reception. If the Whitening for Life is not required/unavailable to you this treatment
CANNOT be swapped for a cash value or voucher.
Signature_____________________________________
Date ___________________________
FREE TEETH WHITENING FOR LIFE PROGRAM
Free Teeth Whitening for Life is a loyalty and rewards program that is a courtesy and privilege, compliments of
CADIS. This program is for patients who take care and maintain their oral hygiene and general dental health. We
believe it is extremely important to maintain recommended dental appointments and receive necessary dental
treatment to maintain a healthy and beautiful smile. Consequently, we developed this program to reward patients
who do so.
There are two ways to qualify and there are no joining costs. It’s free.
What you get:

We provide you with an upper and lower whitening trays

Each time you visit us for your dental appointment, we will give you a tube of whitening gel (2 tubes
of whitening gel per year)
How to Join Us:
New Patients
While at your first dental appointment you will complete a comprehensive exam by dentist, x-rays (if required),
and an appointment for a hygiene visit with either the dentist or hygienist..
At your next hygiene appointment (usually 3, 4 or 6 months later) we will take impressions of your teeth and give
you your tube of whitening gel to start your whitening treatment at home. Twice per year at your dental check up
and hygiene visit for your s, we will give you one whitening gel. To remain eligible for the Free Whitening for Life,
it is essential that patients must maintain at least two dental hygiene cleanings and checkups per year.
Existing Patients
If you are currently on our Gold Membership Plan, we can upgrade you to our Platinum Membership. This will
then entitle you to our Free Whitening for Life. At your next dental appointment, we will take impressions for your
whitening trays and give you your tube of whitening gel to get started on your home whitening. Each time you
visit for your scheduled dental hygiene appointment, we will give you one tube of whitening gel. To remain eligible
for the Free Whitening for Life Program, patients must maintain at least two dental hygiene cleanings and
checkups per year.
This privilege, while free, does have some rules. Below is a brief description of these rules. Please read through
them carefully and sign below, acknowledging that you understand how Free Teeth Whitening for Life works.
Patient Activation Rules:
1.
Must be at least 18 years of age.
2. New Patients must complete initial check up and hygiene cleaning, any necessary x-rays, re-appoint for
hygiene care.
3. Must comply with minimum required dental care as stated by the dentist. Patients must not have active,
untreated disease – gum (periodontal) disease, decay (caries), root sensitivity, oral cancer, etc.
4. Must make all scheduled appointments. Cancellations must be made with a minimum of 24 hour notice
and the appointment must be rescheduled within the next 2 weeks.
5. Must not have any outstanding bills with CADIS and comply with our Financial Policies.
6. Must have at least six-month patient history without any broken appointments.
Upon meeting these requirements, patients will receive complimentary professional whitening trays.
Lifetime Maintenance Rules:
1. Must maintain minimum continued dental care as stated by the dentist and hygienists of CADIS.
2. Must maintain continued hygiene care with CADIS as specified by the dentist and hygienist (usually six month
hygiene appointments).
3. Must comply with all CADIS policies regarding payment and broken appointments.
4. A maximum of one whitening treatment will be given at each routine appointment, with a maximum of twice
annually.
5. Lost or destroyed trays will be replaced at a cost of £75 to the patient.
6. Should any of the rules fail to be met, you will immediately be disqualified from the program and provided the
opportunity to re-enrol for a £50 fee.
*All patients will receive their whitening package upon completion of all necessary dental treatment, as
determined by the dentist. Patient must not have active, untreated disease – gum (periodontal) disease, decay
(caries), root sensitivity, oral cancer, etc. Should no dental treatment be required to maintain healthy teeth and
gums, the whitening package will be given upon completion of a follow-up visit (typically six months). Minimum
gum and teeth health is required to receive professional whitening in order to prevent complications that may arise
with unhealthy teeth and gums.
**If new patients wish to receive whitening before their second hygiene re-care visit, and the dentist determines
the patient’s mouth is healthy enough for whitening, the patient may purchase the whitening trays and gel at their
first appointment and begin whitening. Free Whitening for Life will commence at the second dental/ hygiene visit.
While for many, whitening can boost confidence and improve the appearance of your smile, it is important to note
that it is not for everyone.
Here are a few key pieces of information to consider before whitening your teeth:

Whitening success is not always predictable, whitening procedures may not be effective on some
teeth.

The active ingredients in teeth whitening are hydrogen peroxide and/or carbamide peroxide in a
glycerine base. If you know of any allergy or adverse reaction to either ingredients please do not
proceed with treatment.

Whitening can only be done in a healthy mouth.

Fillings and crowns do not whiten, and may need to be replaced if you wish to have colour rematch.

The amount of colour change is difficult to predict and desired results cannot be guaranteed.

Whitening may cause sensitivity, which can normally be controlled.

Some causes of discoloration are more difficult to whiten (tetracycline staining usually takes 6
months).

Colour stability varies and you should wait at least 2 weeks after whitening is completed for
additional cosmetic procedures.

As with any treatment, there are benefits and risks. The benefit is that teeth can be whitened fairly
quickly in a simple manner. The risk involves the continued use of the peroxide solution for an
extended period of time. Research indicates that using peroxide to whiten teeth is safe. There is
new research indicating the safety for use on the soft tissues (gingiva, cheek, tongue and throat).
The long term effects are as yet unknown. Although the extent of risk is unknown, acceptance of
treatment means acceptance of risk.

Whitening solutions are designed to lift stains from natural teeth and do not affect the colour of
fillings, porcelain or metallic dental work

Your home care and professional cleaning are the foundation of a healthy smile - after all deposits
left on the teeth are a main cause of tooth discoloration
Disclaimer: Any doctor or staff member of CADIS has the right to void this offer if deemed necessary based on
patient health conditions, misuse, abuse, or any other factor as determined by CADIS staff. A minimum gum and
teeth health status is required to receive professional whitening. CADIS reserves the right to change product type
amount, frequency of distribution, terms of agreement and refusal of distribution for whatever reason necessary.
I, ___________________________________ hereby certify that I agree to the terms and conditions outlined above,
and acknowledge CADIS appointment and Financial Policies. I understand that ‘Free Professional Teeth Whitening
for Life’ is a treatment only bestowed to individuals who meet and maintain all of the rules and regulations
pertaining to it.
Signature
Date
_________/___________/__________