BACK
CONSULTATION
CHECKOUT
Have you been diagnosed with any of the following?
Temporomandibular Joint Disorder (TMJ)
Temporomandibular Disorder (TMD)
Bruxism (teeth grinding or clenching)
Sleep Apnea
None of the above
CONTINUE
BACK
Have you undergone any recent dental surgeries or procedures?
Yes, within the past 6 months
Yes, but more than 6 months ago
No
CONTINUE
BACK
Is your bit misaligned (i.e., overbite, underbite, or crossbite)?
Yes, I have a noticeable misalignment
No, my bite is properly aligned
I'm not sure
CONTINUE
BACK
Do you have "buck teeth" or prominent front teeth that extend significantly beyond the lower teeth?
Yes
No
I'm not sure
CONTINUE
BACK
Do you currently wear braces or a dental retainer?
Yes, I wear braces
Yes, I wear a retainer
No
CONTINUE
BACK
Just a moment — we’re getting your secure payment page ready.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
.svg)