**Complete this form only when instructed to do so by your dental care team.
Please submit your information via the fields below, and we will reach out to you as soon as possible to schedule a virtual visit with Dr. Heckler at your convenience!
Include your six photos, matching what you see below. You can use two home objects, such as spoons, to assist in retracting your cheeks. In bright lighting, hold your camera horizontally and get as close as you can to your teeth, while still showing the whole mouth. In any photo you take and the example is biting down, please stick your tongue to the roof of your mouth and as far back as possible, and bite on your back teeth. The more detail and clarity, the better your doctor can use these photos for the diagnostic process.
TIPS and TRICKS for best photos: