1. What is the biggest problem that you’re having with your teeth right now:
Please select answer that best describes you
I'm missing 1-2 teeth
I’m missing more than 2 teeth
I want to get rid of my denture
I need to have 1 or multiple teeth removed
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2. Why haven’t you fixed the problem yet?
2. Why haven’t you fixed the problem yet?
I haven’t found a dentist I trust
I haven’t had the time to get it done
I can't afford to have the procedure; but I want it.
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3. What would be the biggest benefit if we could help you fix this problem?
3. What would be the biggest benefit if we could help you fix this problem?
I would love to smile with confidence again
It would be great to eat normally again
My teeth wouldn't hurt me anymore
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4. If you could fit implants into your budget are you ready to start right away?
4. If you could fit implants into your budget are you ready to start right away?
Yes
No
Maybe, let's discuss options
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