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- Which platform did you first reach out to me from?
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Format: (000) 000-0000.
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- My hours of operation are Tuesday through Thursday from 10am-4pm ONLY.. Do my hours of operation match your scheduling needs?
- How soon are you looking to book your appointment? Please note 🗒️ specific date may or may not be available ‼️
- Do you prefer morning or afternoon appointments?
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- I agree that I am over the age of 18, am NOT under the influence of alcohol or drugs, am NOT pregnant or nursing, and desire to receive the Tooth Gem procedure. The general nature of the Tooth Gem procedure has been explained to me.
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- Do you have and allergies or sensitives to dental materials?
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- Do you have sensitive teeth?
- Do you wear a retainer?? A retainer is an appliance that a dentist usually gives you after you have had braces to keep your teeth aligned. If you DO wear a retainer then you are not eligible to receive the tooth gems since it can affect the longevity..
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- Should be Empty: