Active Treatment Release

Dr Abhijit Gune has informed me that the Orthodontic treatment performed has been completed as per our agreement.

I have had the opportunity to ask questions and voice any concerns I may have regarding this treatment, and am very satisfied with the results.

I authorize the removal of appliances/braces and placement of retainers to begin the retention phase of treatment.

I would like to purchase Retainer Insurance.

I allow the use of the patient's photo and information for marketing and educational purposes.