HELLO MY TEETH | CLEAR ALIGNER CONSULTATION CHECKLIST
Prepared October 29, 2026 | https://hellomyteeth.com/blog/clear-aligner-consultation-checklist.html
Use locally or print. This worksheet does not submit any information.

Appointment date: __________ Provider/practice: __________________
Country and currency: ______ Quote date and expiry: ______________
Prescribing clinician / registration jurisdiction: _______________
Clinical contact and route to in-person care: ____________________

1. What is the treatment objective and what falls outside the plan?
________________________________________________________________
2. Why is one-arch or two-arch treatment proposed?
________________________________________________________________
3. What examinations, records, imaging and visits are required?
What is included and what is charged separately?
________________________________________________________________
4. Are attachments, IPR or elastics proposed? Where and at what fee?
________________________________________________________________
5. Total cash price, deposit and offer expiry:
________________________________________________________________
6. Financing term, interest/fees and total payable, if relevant:
________________________________________________________________
7. Refinement allowance, expiry, records and appointment charges:
________________________________________________________________
8. Retainers included, delivery and replacement costs:
________________________________________________________________
9. Monitoring schedule and responsible professional:
________________________________________________________________
10. Cancellation rules and fabrication/shipping cutoff:
________________________________________________________________
Unanswered questions to confirm in writing:
________________________________________________________________
This is an editorial appointment organizer, not a clinical assessment.
Hello My Teeth sells clear aligner treatment. Compare written care and
fee proposals rather than assuming package names cover the same work.