Send us some photos

Don't forget to enter the promo code from our chatbox - after sending your photos, we will email you a $250.00 discount coupon for your new smile!

This page works best on your mobile device. If you are on your computer, open your phone or tablet's camera and scan the below QR code:

From your mobile device, upload a few photos, which {CompanyName} will review. We'll then put together a custom treatment plan explaining all of your options - including pricing and treatment time.

Full Name

Email

Mobile Phone

Photo #1 Smile wide! Pull back your cheeks with a finger on each side to snap this shot (you may need a friend to take the picture). And remember to take the picture straight on.

Click to take Smile Picture

Choose file

Photo #2 Pull your left cheek so we can see your side teeth. Bite your back teeth tight together for the photo.

Click to take Left Picture

Choose file

Photo #3 Pull your right cheek toward your ear so we can see your side teeth. Bite your back teeth tight together for the photo.

Click to take Right Picture

Choose file

Photo #4 Tip head back and open really wide. Use one hand to keep your upper lip out of the way.

Click to take Upper Picture

Choose file

Photo #5 Tip head down and open really wide. Use one hand to keep your lower lip out of the way.

Click to take Lower Picture

Choose file

If feasible, which would you prefer?

Invisalign Clear Aligners

Clear Braces

Metal Braces

Tell us what concerns you the most?

In order to help us provide you with the most accurate fee for your customized treatment, please snap two quick photos of your insurance card and we will look into your coverage and benefits. *Not required.

Front of Insurance Card(optional)

Choose file

Back of Insurance Card(optional)

Choose file

Promo Code(optional)

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