When was your last dental visit?
1 year or less
1 to 3 years
3 to 5+ years
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What Best Describes Your Condition?
I Have All My Teeth
I'm Missing One Tooth
I'm Missing Multiple Teeth
I'm Missing All My Teeth
How Long Have You Been Missing Your Teeth?
I'm Not Missing Teeth
Less Than A Year
More Than A Year
Do You Currently Have Any Of The Following Treatments?
Crowns and/or Bridges
None of the Above
Are you self-conscious or embarrassed by your teeth and or smile?
Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods?
What Is The Most Important Outcome You Are Seeking?
Function - Eating, Chewing, Talking
Aesthetics - Beautiful, Natural Looking Teeth
Both Are Equally As Important
What Is The Most Important Factor That Has Prevented You From Getting Treatment?
Can't Find The Right Dentist
What Is your Level of Urgency To Find Relief From Any Type Of Pain Or Discomfort That You May Be Feeling?
1 - Very Little, I'm Not In A Rush
2- Moderate, I-3 Months
3 - High, I'm Looking For Help Now!
Have You Had Treatment Plans From Other Doctors For Dental Implants Recently?
Are you interested in financing options?
Yes I am!
No I will not need a payment plan
What Dollar Range Would You Like To Pay Monthly?
Payment plans are based on credit approval, you may also bring in co-signer. If you could guess, what is your credit score?
551 - 600
601 - 650
651 - 700
I don't know my credit score
Do you work with state funded insurance?