Professional Teeth Whitening For Life



Professional Teeth Whitening for Life is a courtesy and a privilege compliments of Premier Dental Group PLLC of Knoxville. This program is extended to patients who have proven themselves as individuals who take their oral hygiene and general dental health seriously. We believe it is extremely important to maintain recommended hygiene care appointments and receive necessary dental treatment to maintain a healthy and beautiful smile.
We pride ourselves on the smiles that leave our practice. Professional Teeth Whitening for Life was developed as a free gift for those patients who are already taking their dental health seriously, and as an incentive for those who need a little help keeping up with their dental care.
New patients will receive a one-time, custom-made, professional take-home whitening tray for personal use; plus (1) one whitening solution refill at each subsequent hygiene visit at no charge if program guidelines are met. Existing patients will be charged a one-time fee of $50 for the tray and refill.

While Professional Teeth Whitening for Life is a gift from us to you, the program does require some rules:


NEW PATIENTS’ ACTIVATION & MAINTENANCE GUIDELINES

  • Must be a New Patient of Premier Dental Group PLLC of Knoxville to receive the no-cost entry into the program.
  • Must be 16 years of age or older.
  • Must complete initial hygiene cleaning, x-rays, doctor exam and make a followup appointment for (3-month, 4-month or 6-month) re-care. At that time of the followup appointment and after necessary treatment has been started, impressions will be taken for a professional whitening system and trays will be available within two weeks.
  • Must make all scheduled appointments. Cancellations must be made with a minimum 48-hour notice and original appointment rescheduled within the next two (2) weeks.
  • Will be disqualified from the program and given the opportunity for re-enrollment at a $100 re-activation fee if all guidelines are met.
  • Ask how to buy additional whitening tubes from one of our team members!

EXISTING PATIENTS’ ACTIVATION & MAINTENANCE GUIDELINES

  • Existing Patients at Premier Dental Group PLLC of Knoxville who would like to join the program will be charged a one-time fee of $50 to receive the custom whitening trays and (1) one tube of whitening (value of $300). Patient will be eligible to receive the trays within (2) weeks of paying the $50 one-time enrollment fee.
  • Must be 16 years of age or older.
  • Must complete initial hygiene cleaning, x-rays, doctor exam and make a followup appointment for (3-month, 4-month or 6-month) re-care. At that time, impressions will be taken for a professional whitening system and trays will be available within two weeks.
  • Must make all scheduled appointments. Cancellations must be made with a minimum 48-hour notice and original appointment rescheduled within the next two (2) weeks.
  • Will be disqualified from the program and given the opportunity to re-enroll for a $100 re-activation fee if all guidelines are met.
  • Ask how to buy additional whitening tubes from one of our team members!

LIFETIME MAINTENANCE GUIDELINES

  • Must maintain continued hygiene care (3-month, 4-month, or 6-month schedule).
  • Must comply with all Premier Dental Group PLLC of Knoxville policies regarding payment or broken appointments.
  • Appropriate whitening solution refills will be presented at your hygiene visits.
  • Lost or destroyed trays will be replaced at a cost to the patient of $100 each.

Disclaimer: Premier Dental Group PLLC of Knoxville has the right to refuse this offer if deemed necessary based on patient’s health conditions, misuse, or abuse.

Download Forms to Fill Out Before Your Visit

PRINTABLE PATIENT FORMS



NEW PATIENT FORM

New patient? Download your first form here to save time during your visit!


CONSENT FOR TREATMENT

Consent for treatment form so we can help you toward a lifetime of smiles.


COVID-19 TREATMENT CONSENT FORM

Consent to have dental treatment completed during the COVID-19 pandemic.

MEDICAL RELEASE FORM

Download this form to give us permission to share your records with you.


HIPPA AGREEMENT FORM

Complete this form if you plan to make an agreement for your service.





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(865) 637-5708



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303 S. Concord
Suite 323
Knoxville, TN 37919



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