FIND OUT IF I AM A CANDIDATE
How Many Teeth Are You Currently Missing?
*
All
6+
4-5
3 Or Less
What Is Your Age?
*
60+
50-59
40-49
40 or less
Do you currently have any of these dental solutions?
*
Denture or Partial Denture
Bridge, Crown
Dental Implant
None of the above
How Long Have You Been Missing Your Teeth? (The longer teeth are missing the more the jaw bone shrinks)
*
I still have them
1-6 Months
7-12 Months
1+ Years
When was the last time you were seen by a dentist?
*
Within a year
More than 2 years
More than 5 years
10+ years
Are You Currently Trying To Find Relief From Any Kind Of Pain Or Discomfort?
*
Yes
No
Are You Currently Unable To Eat Certain Foods Or Have To Modify The Way You Chew?
*
Yes
No
Are You Currently Experiencing A Lack Of Confidence In Social Situations or Find Yourself Hiding Your Smile?
*
Yes
No
Do you own your own home?
*
Yes
No
Have You Had A Dental Implant Consultation With Another Dentist?
*
Yes
No
What is your desired outcome?
*
Restore my smile
Improve my chewing function
Both
Other
How Ready Do You Feel To Do Something About Your Situation?
*
Somewhat Ready
Very Ready
I Need Something Fast!
Dental Implant procedures are not covered by insurance. However, many affordable payment plans are available. Are you interested in a payment plan option?
*
Yes. I'm interested in affordable payment plan options
No. I've been saving for this type of procedure and will not need a payment plan
Which of the options below most accurately represents your current credit score?
*
(Excellent) 750+
(Good) 650-749
(Fair) 600-649
(Poor) Under 599
Which best described your current household monthly income?
*
Over $8,000
$4,000-$8,000
Under $4,000
First Name
Last Name
Phone
*
Email
*
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terms & conditions
provided by the company. By providing my phone number, I agree to receive text messages from the business.