Do You Currently Have Any Of The Following Treatments? *

Crowns and/or Bridges

Partials

Dentures

None of Above

Have You Experienced Any Type Of Insecurities Regarding The Way Your Teeth Look? *

Yes

What Best Describes Your Condition? *

I Have All My Teeth

Missing One Tooth

Missing Multiple Teeth

Missing All My Teeth

Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods? *

Yes

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? *

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? *

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? *

Yes

Dental Implant procedures are not covered by insurance. However, we offer many affordable payment plans. Are you interested in a payment plan option? *

Yes

Which best describes your credit? *

(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? *

Under $5,000

$5,000 to $8,000

Over $8,000

Which of our locations is most convenient? *

Charleston

Greenville

First Name *

Last Name *

Phone *

Email *

I understand that this dental practice provides professional treatment with financing options and does not participate in "free dental" or "grant" promotions advertised online.