I understand that this dental practice provides professional treatment with financing options and does not participate in "free dental" or "grant" promotions advertised online.
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I understand
What Best Describes Your Condition?
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I Have All My Teeth
Missing One Tooth
Missing Multiple Teeth
Missing All My Teeth
Do You Currently Have Any Of The Following Treatments?
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Crowns and/or Bridges
Partials
Dentures
None of Above
Have You Experienced Any Type Of Insecurities Regarding The Way Your Teeth Look?
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Yes
No
Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods?
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Yes
No
What Is The Most Important Outcome You Are Seeking?
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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?
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Time
Money
Fear
Cannot 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?
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Very Little, Not In A Rush
Moderate, 1-3 Months
High, Looking For Help Now!
Have You Had Treatment Plans From Other Doctors For Dental Implants Recently?
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Yes
No
Dental Implant procedures are not covered by insurance. However, we offer many affordable payment plans. Are you interested in a payment plan option?
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Yes
No
Which best describes your credit?
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(Building Credit) Under 600
(Growing Credit) 660-699
(Strong Credit) 700-739
(Excellent Credit) 740+
Many patients who believed they would not qualify for financing were still able to move forward with their smile transformation. We will guide you through every option so you never feel discouraged!
Which best describes your current household's monthly income?
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Under $5,000
$5,000 to $8,000
Over $8,000
Which of our locations is most convenient?
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Charleston
Greenville
First Name
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Last Name
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Phone
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Email
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