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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!

    #1 Front - No Smile*
    #2 Front- Smiling*
    #3 Profile*
    #4 Lower Teeth*
    #5 Upper Teeth*
    #6 Front View*
    #7 Right View*
    #8 Left View*

    *maximum upload file size 3MB Each





    Limited Treatment (Braces or Invisalign, minor corrections only)Comprehensive Treatment (Braces or Invisalign, complete alignment of all teeth and bite correction)


    YesNo



    mild, or no crowdingmoderateextreme


    mild, or no extra spacemoderateextreme