Client Intake & Booking Information
Effective Date: June 23rd, 2026
1. Whitening Sessions Overview
Orisha Teeth Whitening provides non-medical cosmetic whitening services designed to enhance the appearance of natural teeth. Results vary by individual.
Clients should be aware that:
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Teeth whitening is a cosmetic service and outcomes are not guaranteed
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Existing dental restorations (crowns, veneers, fillings, or similar work) do not whiten
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Temporary sensitivity or mild irritation may occur during or after services
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Services are self-administered with professional guidance provided by staff
2. Health Considerations
Clients should be aware of the following prior to booking:
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Services may not be suitable for individuals with untreated oral discomfort, irritation, or active oral conditions
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Recent oral procedures may require a waiting period before receiving services
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Cosmetic whitening may not be recommended for individuals who are pregnant or breastfeeding unless cleared by a medical professional
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Individuals with known sensitivities to whitening or peroxide-based ingredients should exercise caution
3. Booking Requirements
All clients are required to complete applicable booking forms prior to receiving services. This ensures accurate information is provided and service policies are acknowledged.
4. Service Policies
By proceeding with a booking, clients acknowledge that:
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Aftercare guidance is provided following services
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Appointment, cancellation, refund, and no-show policies apply
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All relevant service policies should be reviewed prior to booking
5. Minor Participant & Parent/Guardian Consent
If the participant is under 18 years of age, parent or legal guardian information is required. By completing the fields below, the parent or legal guardian confirms responsibility for the participant and acknowledges consent for services in accordance with Orisha policies.
This information must be provided if applicable to the client receiving the service.
6. Contact Information
If you have questions regarding this document or our policies, please contact:
Orisha Teeth Whitening
1521 Locust St.
Philadelphia, PA 19102
445.202.9737
support@orishateethwhitening.com
orishateethwhitening.com
Version Note: This document may be updated periodically. Continued use of services constitutes agreement to the most current version.