Do you like your smile?
I love it.
I am conscious of it.
I have seen worse.
I hate it.
Have you previously undergone orthodontic treatment?
Yes
No
Are you experiencing any discomfort or pain related to your teeth alignment?
Yes
No
What has kept you from fixing your smile?
*
Nothing! It just happened and I am ready right now.
Fear of dental procedures
Time involved in dental procedures
Cost of dental procedures
I have not found a dentist I am comfortable with yet
What matters most to you about your orthodontic treatment?
Quality
Low Payments
Speed of Treatment
I do not want metal braces
Have you seen another dentist for your current issue?
*
Yes
No
Do you have a preference for a specific type of orthodontic treatment?
Traditional metal braces
Ceramic braces
Clear aligners
Are you interested in exploring accelerated treatment options?
Yes
No
I'm not sure.
How do you plan to pay for your treatment?
*
Cash
Credit Card
Dental Insurance
3rd Party Financing
Is there any other information you would like us to know before your consultation?
First Name
*
Last Name
*
Phone
*
Email
*