Smile Survey
Dental Health & Smile

On a scale of 1 to 10, how satisfied are you with the current condition of your teeth and smile?

Are there specific aspects of your smile that you would like to improve or change? If yes, please describe.

Have you ever considered cosmetic dental treatments, such as teeth whitening, veneers, or Invisalign, to enhance your smile?

How would you describe the health of your gums and overall oral hygiene practices?

Skin Health & Treatments

Are you currently receiving any skin treatments, like Hydrafacial or others? If so, how satisfied are you with the results?

Have you ever considered combining dental and skin treatments to achieve an overall enhanced appearance? Please explain.

Would you be interested in a consultation to discuss how dental and skin treatments can work together to improve your overall appearance and confidence?

How important is it for you to have a healthy and radiant smile in your daily life?

Is there anything specific you would like us to know about your dental and skincare needs or preferences that can help us provide you with the best possible care?

Contact Details

Your Name*

Your Email*

Telephone Number*

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