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How Many Missing Or Broken Teeth Do You Have? *

All

4-5

3 Or Less

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What Is Your Age? *

60+

50-59

40-49

<40

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Do you currently have any of these dental solutions? *

Denture or Partial Denture

Bridge, Crown

Dental Implant

None of the above

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How Long Have You Been Missing Your Teeth? (The longer teeth are missing the more the jaw bone shrinks) *

I Still Have Them

1-6 Months

7-12 Months

1+ Years

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Are You Currently Unable To Eat Certain Foods Or Have To Modify The Way You Chew? *

Yes

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Are You Currently Trying To Find Relief From Any Kind Of Pain Or Discomfort? *

Yes

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Are You Currently Experiencing A Lack Of Confidence In Social Situations or Find Yourself Hiding Your Smile? *

Yes

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Have You Had A Dental Implant Consultation With Another Dentist? *

Yes

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How Ready Do You Feel To Do Something About Your Situation? *

Somewhat Ready

Very Ready

I Need Something FAST!

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Dental Implant procedures are not covered by insurance. However, many affordable payment plans are available. Are you interested in a payment plan option? *

Yes. I'm interested in affordable payment plan options

No. I've been saving for this type of procedure and will not need a payment plan

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National averages for dental implant procedures can range from $22,000 to $55,000. Payment plans start at $300/mo. Would you like to see if you qualify for payment plans, or still continue without? *

Yes, please tell me if I might qualify for a payment plan

No, I don't need a payment plan

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Payment plans are available based on credit approval of the patient or a co-signer. Which best describes your credit? *

(Poor) Under 660

(Fair) 660-699

(Good) 700-739

(Excellent) 740+

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Which best describes your current household monthly income? *

Under $5,000

$5,000 to $8,000

Over $8,000

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When is the best time to contact you? *

Morning

Afternoon

Evening

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Have you seen misleading ads or offers online claiming that dental implant treatments are covered by grants, filming, or other funds? *

Yes

*Please be aware: Some ads out there/online make false promises of full coverage through "dental grants" or insurance. Scammers will create "too good to be true ads" and redirect online traffic to random dental office webpages trying to get referral compensation from ad platforms. We're sorry if you happened to arrive to our page by these means, but what is true is that we do offer financing options and are here to offer honest solutions tailored to your dental needs*

Almost Finished. Where can we send your results?

Full Name *

Email *

Phone *

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