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ZQuiet Success Program

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1. I agree that I am at least 18 years old and do NOT have any of the following conditions: loose, sore, or painful teeth; loose crowns, braces, recent implants; sore gums, oral infections, periodontal disease; jaw soreness or history of TMJ.

2. I understand that I will be charged $69.95 after 30 days if unreturned.

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