Smile Assessment Form
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Find Out if You're a Candidate for Clear Aligners

Answer a few quick questions about your smile and treatment goals. It only takes around 30 seconds.

Once you complete the assessment, our dental team will review your responses and one of our treatment coordinators will contact you to discuss your eligibility and help you choose the best next step.

If you're a good fit, we'll send you an easy-to-use impression kit so you can get started from home.

Assessment Complete

We just need a little more information so that we can send your results.

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Your Main Concern

Please select an option to continue.
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Bite & Teeth Habits

Do You have a Bite Issue?

Please select an option to continue.
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Do You Grind Your Teeth While Sleeping?

Please select an option to continue.
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Oral Hygiene & Gums

Are You up to date with Your Hygiene (Cleaning) Appointments?

Please select an option to continue.
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Do You have any Gum Recession?

Please select an option to continue.
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Do You have any Wobbly / Loose Teeth?

Please select an option to continue.
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Are you over 18 years old?

Please select an option to continue.
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Your next step

Here's how you'll begin your smile journey. Just press Submit to send your assessment.

At-Home Impression Kit

At-Home Aligners

We'll send you an easy-to-use impression kit so you can get started from home.