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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*
#2 Upper Teeth*
#3 Front View, smiling*
#4 Right View*
#5 Left View*

*maximum upload file size 5MB Each



Clear alignersBraces

YesNo


mild, or no crowdingmoderateextreme


mild, or no extra spacemoderateextreme