By requesting a teledentistry consultation you hereby agree to the following: that you wish to receive a teledentistry consultation with an orthodontist; in the absence of radiographs (x-rays), you understand that you may be asked to send photographs or other documentation as requested by the dentist. You agree to provide as much information as you can. You understand that the doctor is limited to what they are able to determine remotely through video or telephone consultation. You also understand and agree that if you are experiencing pain or swelling that is life threatening, that you will call 911 or go to an emergency room. You attest that you are responsible for any payment resulting from this consultation that is not covered by a dental insurance plan. In addition, you understand and consent to this consultation being recorded for clinical documentation and accuracy.