Retainer Instructions Questionnaire
Office Information
Your name
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Your email address
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Doctor or office name
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Office phone number
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Destination URL
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Please enter where you would like this content to live on your website.
Would you like to view/edit the content before it's uploaded?
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General Information
How often should you wear your retainer?
Can you explain the recommended wearing schedule (daytime, nighttime, etc.)?
How do you clean and care for your retainer?
Should you remove your retainer when eating or drinking?
Are there any foods or habits that should be avoided while wearing a retainer?
What should you do if my retainer feels tight or uncomfortable?
How often should you come in for retainer check-ups or adjustments?
What is the lifespan of your retainer, and when should you consider replacing it?
What should you do if you lose or damage your retainer?
Are there any specific instructions for wearing a retainer during sports or physical activities?
How do we create your custom retainer?
Additional Information that could set you apart from your competition?
Do you have any patient testimonials (text or videos) or videos you have created for your practice or the treatments you offer? (Include a link to any YouTube videos you’ve created!)
Do you have before and after photos? If so, please attach them here
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Do you have Sesame Social? If so, would you like us to create and post a blog from your answers as well?
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I don't have Sesame Social!
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