How long have you been dealing with your current situation?*

Are you currently unable to eat certain foods or have to modify the way you chew?*

Do you ever find yourself avoiding social situations because of your teeth? Or hiding your smile when talking or taking photos?*

What has prevented you from taking the next step toward getting help?*

Why do you want to find a solution?*

To personalize your consultation, what’s your full name?*

We’ll use this to send your consultation details and any helpful info. What’s the best email to use?*

We’ll text or call to schedule your consultation. What’s the best number to reach you at?*

Dental implant treatments are not covered by insurance. But don’t worry, there are affordable payment options available.” Which of the following would you be open to using for treatment?*

If approved for a payment plan, what’s a comfortable monthly range you could work with?*

Roughly where do you think your credit score would fall today (if a lender looked)?*

Sometimes, patients with lower credit scores may need a co-signer to get approved for financing.” Do you know someone with good credit (like a spouse or a family member) who could help you apply if needed?*

How soon would you like to start treatment?* (Patients without teeth lose up to 25% of their bone width within the first year. This only increases with a longer wait.)*

Once we receive your info, we’ll call to schedule your free consultation. Can we count on you to answer?*