Specialist assessment
Confirm the diagnostic consultation and required records, including which charges are separate.

UNDERSTAND YOUR QUOTATION
Confirm each service below in your written quotation. This checklist does not mean that every stage is included in the listed item.
Confirm the diagnostic consultation and required records, including which charges are separate.
Ask which impressions, scans or bite records are required to manufacture the prescribed appliance.
Record the appliance design, laboratory work and how remake or replacement requests are handled.
Clarify fitting, teaching the wear and care routine, and how a parent supports the child.
Agree which checks and adjustments are included and how to obtain help with poor tolerance or damage.
Discuss how remaining needs are reviewed and whether later appliances, alignment or retention require a separate plan.
Educational illustrations. Components, clinical suitability and the agreed service scope require an individual plan.
BEFORE YOU DECIDE
Clarify the assessment, records, fabrication, fitting and follow-up covered by the quotation. Ask separately about repairs, replacements and later orthodontics.
No fixed duration or guaranteed change is established by the source. Coordinate visits and continuing support with the specialist’s individual plan.
Illustrative planning scenes. Your written quote and clinical plan define the scope and appointments.
YOUR NEXT STEP
Clarify the diagnosis, appliance prescription, fabrication, guidance, review arrangements and any separately charged later care before committing.
Clinical suitability and appointment dates require confirmation. This form is not for emergencies.
FR III Functional Appliance in China