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Are You A Candidate?

Please complete the form below.

  4. 1. List in priority the things you would most like to
    improve about your smile.
  5. 2. Have you had any previous esthetic dentistry?
    (If no, go to question #4)
  6. a. What was the reason for your previous work?
  7. b. When was your last dental visit?
  8. 3. Do you have any interest in teeth whitening?
  9. 4. If you have never had dental esthetic work, what
    are your realistic desires -- i.e., what will/would it
    take for you to be satisfied with the outcome?
    Think about this and be honest.