Eligibilty Quiz

This will take you 2 Minutes and will help us prepare for your case and also will automatically apply you for special financing or grant offers

How Many Teeth Are You Currently Missing? *

All of Them

5+

3-5

1-2

When did you first notice missing teeth? * Your timeline matters - the longer teeth are missing, the more your jaw bone naturally changes.

Not Missing Any Teeth

Less Than 6 Months Ago

1-3 Years Ago

Over 3 years ago

Are you currently having issues eating certain foods, or unable to eat certain foods, having to modify the way you eat etc.

Yes

No

Are you currently trying to find a solution for this discomfort, or is this impeding your current lifestyle?

Yes

No

Are you suffering regular pain, any Tooth infections currently or do you have toothaches regularly

Yes

No

Is your current situation affecting your social life, lack of confidence, hiding your smile etc.

Yes

No

Have you sought out help from other dentists, or have you had an appointment or consultation with another Implant specialist

Yes

No

How would you gauge your motivation to move forward with a solution such as implants ?

Still Investigating

I am Ready

Urgent - I am VERY READY

YESTERDAY - DIRE SITUATION

While dental implants are not covered by insurance, there are affordable payment plans to help with your treatment. Would you like information about payment options?

YES, Please Share Payment Options

No, I have the means to pay on my own

Not Sure, Let's Discuss

To help find your best financing option, could you share your general credit score range and household income? * (All information is confidential and helps us match you with available payment plans)

Average Household Income

Use numbers only, example $50000/year just type 50000. This is for financial options availability only

What Is your Zip Code

First Name

Last Name

Email *

Phone

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