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The Pearly Girly
Pearly Whites Done Right
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Step 1 of 5
Quick check-in
These questions help us make sure whitening is the right fit for you right now.
1. Do you have veneers, crowns, bonding, or fillings on your front teeth?
Good to know! Restorations (veneers, crowns, bonding, fillings) won't lighten — only natural enamel whitens. This can leave a visible shade difference between treated and untreated teeth. We'll make a note so you know what to expect.
2. Do you currently have tooth pain, visible decay, bleeding gums, or an untreated dental issue?
3. Have you had dental work done in the last 14 days?
4. Are you pregnant or nursing?
5. Are you under 18?
We'd love to see you — just not quite yet.

Based on your answers, we want to make sure you get the best (and safest) results. Please check in with your dentist first, and reach back out once you're cleared. We'll be right here! 🐚
Step 2 of 5
Were you referred?
If a friend referred you, enter their name so they get $25 off their next session!
Step 3 of 5
Your details
We'll use this to confirm your appointment and reach you before your session.
Step 4 of 5
Pick a date
Select your preferred date. All appointments are subject to confirmation — we'll reach out to lock it in!
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Step 5 of 5
Service Waiver
Please read, check, and sign before selecting your time.

Informed Consent & Service Waiver

Nature of Service: The Pearly Girly offers cosmetic teeth whitening using a professional-grade whitening gel. The active whitening ingredient is carbamide peroxide. Results vary based on individual tooth composition, lifestyle habits, and existing dental work.

No Medical Claims: This is a cosmetic service. We are not licensed dentists and do not perform dental exams, give dental advice, or diagnose or treat any dental condition. This service is not a substitute for professional dental care.

Self-Application: During your session, The Pearly Girly provides the equipment and guides you through the process. You apply the whitening tray yourself. You are in control at all times.

Pre-Treatment Disclosure: By signing, I confirm I am not pregnant or nursing, do not have untreated cavities or exposed roots, and have not had dental work within the past 14 days.

Sensitivity: Some clients experience temporary tooth sensitivity following treatment, typically resolving within 24–48 hours. If you have a history of sensitivity or a known sensitivity to peroxide compounds, please inform your provider before treatment.

Results & Our Promise: Individual results vary. If you don't see visible shade improvement, we'll re-treat you once at no charge within 14 days of your session.

Liability Release: I voluntarily consent to this treatment and release The Pearly Girly, its owners, staff, and affiliates from liability for adverse reactions when this form has been completed honestly.

I have read and agree to all terms above and confirm all disclosures are accurate.
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Request received!

Thanks ! We'll reach out to to confirm your appointment time and whether we're coming to you or you're coming to us. ✨

Questions in the meantime? DM us on Instagram.