Smile Consultation FV-SF

Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
City & State*
Please provide your age*
Date of birth?*
Select desired consultation time.*
When was your last cleaning?*
Do you currently smoke or have a history of smoking tobacco products?*
Are you currently missing any teeth?*
Where will you be traveling from for your treatment?*
What date(s) are you looking to begin treatment?*
Is there anything else you’d like our team to know about your oral health, goals, or expectations before your consultation?*
How will you be paying for your smile makeover?*

CASHCREDITFINANCINGCARE CREDIT
What is your credit score?
How did you hear about Forever Veneers*
Please select desired full smile makeover service.*

Porcelain VeneersPorcelain CrownsPorcelain Bridge/sZirconia VeneersZirconia CrownsZirconia Brdige/sDental ImplantsAll On 4 - All On 6 ImplantsGum ContouringCavity ReapirDeep Cleaning
When you imagine seeing your before and after, what are you most excited to feel in that moment? (Select all that apply)*

ConfidenceHappinessPowerReliefCompletionPeaceAll of the above
Do you currently wear dentures?*
Do you have any missing teeth? If yes, how many?*
What matters most to you in your smile makeover process?(Select all that apply)*

Convenience and flexibilityMaterial quality and resultsLife span (20-30 Years)Durability and strengthCustomization and design controlDoctor improving overall healthAll of the above
What’s the first word that comes to mind when you see your current smile in the mirror?*
How long have you been waiting for your smile makeover. *
If your smile finally matched how you feel on the inside, what would that unlock for you personally and professionally?*
How to Take Your Perfect Preview Photos

To help our design team create your dream smile, please follow these simple photography guidelines. Clear, well-lit photos are essential for an accurate and personalized design preview.

📸 Photography Setup Checklist:

Lighting: Take pictures in a bright, evenly lit room (natural daylight is best). Avoid shadows on your face and ensure the light source is in front of you.

Background: Stand against a plain, solid-colored wall (white, light gray, or cream is ideal).

Camera & Lens: Use the back (main) camera on your smartphone or a digital camera. Wipe the lens clean with a soft cloth before starting.
Your Pose:
- Look directly at the camera.
- Frame the photo from your collarbone up.
- Gently tuck your chin down slightly.
- Pull your hair fully away from your face.
Show a big, natural, relaxed smile that shows all your teeth.

Take a few photos with your lips relaxed and teeth apart, and a few with your lips slightly open to show your natural tooth shape.

Photo Requirements:

Please upload 3-5 different photos from your session.

Check each photo for quality before uploading. Ensure it is in focus, high-resolution, and well-lit.

DO NOT use filters, beauty modes, or digital zoom.
Upload Photos

Upload Instructions:
Please upload clear photos of your full face smiling and multiple angles of your teeth below. All photos are confidential and will not be shared.

📸 Photo Tips:
- Use bright, natural light
- Keep the camera clean and still
- Avoid filters or camera effects
- Front camera or help from a friend is fine
- Make sure images are clear
1. Upload a picture of your natural smile. *

EXAMPLE BELOW
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2. Upload a photo of your teeth together with the top and bottom closed tightly.*

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3. Upload a photo of the left side of your teeth while smiling with your teeth tight together.*

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4. Upload a photo of the right side of your teeth while smiling with your teeth tight together.*

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5. Upload a photo of the top teeth and roof of your mouth.*

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6. Upload a photo of your bottom teeth from above.*

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A $995 non-refundable deposit is required to book your service and begin treatment.Your treatment space is only reserved once your deposit is received. No obligation to continue beyond your initial plan.*

I AGREE
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📸 Photo Tips: