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Statement of Patient Consent I, ____________________________________,have been given enough time and opportunity to read and understand the information in this informed consent and ample time and opportunity to ask questions. All my questions have been answered to my satisfaction. I have had sufficient time to consider whether to participate in this study. I understand that my participation in this study is entirely voluntary and that I may withdraw from the study at any time without penalty. I understand that the study device is for my exclusive use only. I will not share it with anyone and will store it in a safe place away from children or others for whom it is not intended. The study orthodontist/dentist has my permission to tell my regular doctor about my being in this study: YES NO I voluntarily consent to participate in this study and will be given a signed copy of this form to take home with me. Subject’s Signature ____________________________ Date___________________ (Please also initial each page of this Informed Consent Form) Statement of Person Obtaining Consent: To the best of my knowledge, the information that I, _____________________________ 93PDF Image | Effect of LED Phototherapy on the Rate of Orthodontic Tooth Movement
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