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Please answer the following so we can prepare for your visit! ChapstickSunglassesBlanketNeck PillowHeadphones
We know many patients feel some anxiety about their visit, and we want to help you discover the best experience in healthcare. Please check any of the following statements that describe you. I have a strong gag reflexI am fearful about not being able to breathe properlyI am fearful that I'll experience painI prefer minimial conversation when I'm in the dental chairI enjoy ongoing conversation and explanations during my careI'm fearful I won't have any control over what's happeningI don't feel fearful of dentistry
Please let us know if there's a beverage you'd enjoy before your appointment. WaterCoffeeTeaJuice
What are you most interested in discussing with us? Teeth straighteningProfessional teeth whiteningExploring cosmetic options for a better smileSleep healthReplacement options for missing teeth
To help us understand your dental history, please tell us about your last dental experience or your overall feeling about recent treatment. GreatAverageTerribleNEVER AGAINOther (Please specify)
Is there anything else you'd like us to know that would help us prepare for your visit?