Step #1

Selfie With Smile!

(Whole Head)

Step #2

Smile From Front

(Teeth Up Close)

Step #3

Open Wide!

(Bottom Teeth Looking Down)

Step #4

Open Wide!

(Top Teeth Looking Up)

Step #5

Left side

Step #6

Right Side

Step #7

Insurance Card
(not required)

Step #8

Help Us Get
To Know You!

Step #9

Confirm Your
Phone Number!

Review and Submit

First Name:
Last Name:
Email:
Patient Age:
ZIP:
Phone:

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