Section 4. Patient's exemption.
If the patient or legal guardian for the patient shall for reason of privacy or personal wishes refuse to have any upper and lower denture, removable partial dental prosthesis or removable acrylic orthodontic appliance covered under this act to be labeled, a signed and dated copy of a release to the effect shall accompany the denture to the laboratory fabricating the denture. The original signed and dated release shall be kept in the patient's dental record.