Skip to main content

Book Your Free Virtual Consultation Today!

    Patient Info


    Upload Photos

    If you can submit your photos, that will help us determine your treatment plan before your visit! Photos are optional but recommended 🙂


    #1 Lower Teeth

    Open your mouth wide and tilt your chin downwards toward your chest. Hold the camera so it’s perpendicular to the biting surfaces of your bottom teeth. Make sure your full arch is showing and then snap a picture.


    #2 Upper Teeth

    Open your mouth wide and lift your chin as high as you can. Hold the camera so that it’s perpendicular to the biting surfaces of your top teeth. Make sure you can see the full arch and then click.


    #3 Front View, smiling

    Bite down so your back teeth touch. Directly facing the camera, smile wide and click, trying to get as many teeth as you can in the picture. If you need to, you can pull your lips and cheeks away from your teeth with your fingers to show more teeth.


    #4 Right View

    Bite down so that your back teeth touch, smile and retract the cheek and lips with your finger on the right side of your mouth to expose more of your teeth. Take a picture of the right side.


    #5 Left View

    Bite down so that your back teeth touch, smile and retract the cheek and lips with your finger on the left side of your mouth to expose more of your teeth. Take a picture of the left side.

    *maximum upload file size 1MB Each



    Clear alignersBraces

    YesNo


    mild, or no crowdingmoderateextreme


    mild, or no extra spacemoderateextreme


    Crossbite (Back Teeth)Crossbite (Front Teeth)CrowdingSpacingOverbiteOverjetAbnormal EruptionOpen Bite