Virtual Consultation
Help us answer a few questions to better assist your smile!
Who is it for? (Select One)
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My Child (7 - 11yr)
My Teenager (12 - 18yr)
Adult (18+)
I feel like my teeth are ____________.(Please choose up to two option(s) below)
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Please check atleast one field
Overbite
Underbite
Crossbite
Crooked Teeth
Open Bite
Gap Teeth
Other
Your First Name
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Last Name
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Date of Birth
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Phone Number
Your Email Address
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What else do we need to know?
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Upload Your Photos
Submit your information via the below fields and our Treatment Coordinator will get back to you as soon as possible with a preliminary treatment plan. If more detailed records are needed to allow the doctor to make a better decision about which treatment plan is best for you, we will reach out to you with that information. All treatment plans are tentative until full records are obtained as certain conditions may not be visible with images alone (bone loss, missing teeth, extra teeth, implants placed, etc).
All photos should be taken sitting in a seated position. You will need a friend or family member to serve as your photographer as it's difficult to try and take each of the photos below by yourself.
Images must be a .jpg, .jpeg, .png, or .gif and cannot exceed 20MB.
Photo 1
Front teeth biting down
Photo 2
Right back teeth biting down
Photo 3
Left Back teeth biting down
Photo 4
Top teeth
Photo 5
Bottom teeth
Photo 6
Front teeth Slightly opened