Eligibility

Pre-eligibility assessment.

Leave your name and phone number; the clinical team gets back to you within 24 hours for a first look. If you have an X-ray, you share it at the next step.

1. Leave your name and phone number.

2. The clinical team gets back to you within 24 hours.

3. You share your X-ray at that step; if it fits, we discuss the treatment and travel plan.

This form does not diagnose; it collects information to prepare for doctor assessment.

72 Hour Smile Plan

Your name and phone number are enough.

Add an email address or a message (optional)