The Teeth Whitening (Non-Dental / Spa) Consent is a ready-to-use healthcare & wellness template you can send for signature in minutes. It is written for 1 signer (client) and, by default, expires 30 days after it is sent if left unsigned. It covers teeth whitening, cosmetic, non dental, spa, peroxide, consent. Like every Abundera Sign template it is a convenience draft structured for ESIGN Act and UETA compliance, not a substitute for legal advice. Each signed copy is sealed with PAdES-LTA digital signatures, dual RFC 3161 timestamps, and a tamper-evident evidence package in WORM storage.
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# Teeth Whitening (Non-Dental / Spa) Consent > **Important — not medical advice.** For use by a licensed/qualified provider; screen for contraindications including existing dental work, active cavities, gum disease, and sensitivity history before applying any whitening agent. This service is a cosmetic procedure performed in a non-dental setting. It does not constitute dental treatment and does not replace regular dental care. Clients are encouraged to consult a licensed dentist before whitening if they have any oral health concerns. --- ## Facility & Client Information **Facility Name:** ___________ **Technician / Aesthetician Name:** ___________ **Service Date:** ___________ **Client Full Name:** ___________ **Date of Birth:** ___________ **Phone Number:** ___________ **Email Address:** ___________ **Is this your first teeth whitening service?** ___________ --- ## Service Details **Whitening System Used:** ___________ **Agent Type:** ___________ **Agent Concentration (%):** ___________ **Number of Whitening Sessions Planned Today:** ___________ **Session Duration per Application (minutes):** ___________ **Accelerator Light Used:** ___________