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1. What is your biggest concern with your teeth?
I'm embarrassed to smile
Food gets stuck between my teeth
My teeth are crooked
I have gaps
Something else
2. Are you worried about feeling uncomfortable with the look of traditional metal braces?
Yes
No
3. How would it feel if we could help you fix this problem?
I could smile with confidence again
I would not have to worry about my teeth cracking
I would be healthier because I could better clean my teeth
4. If you could fit Invisalign into your budget, are you ready to start right away?
Yes
No
5. Would you like for us to contact you to schedule a FREE consultation?
Yes
No
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