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Patient pre-evaluation

Help us plan your smile before you arrive

Dr. Daniel reviews your answers and photos before your appointment. It takes about 5 minutes.

About 5 minutes
Only Dr. Daniel and his team see it

Step 1 of 5

Let’s start with you

First name *

Last name *

Email *

Phone / WhatsApp *

A little more about you

Country *

Date of birth *

Instagram or other social media (optional)

Your health

Do you have any pre-existing medical conditions? (diabetes, high blood pressure, heart condition, etc.)

YesNo

Do you take any medication for it?

YesNo

Are you allergic to any medication?

YesNo

Your smile

Upload up to 6 photos: smiling from the front, from each side, and a close-up of your teeth. Good light, no filters.

Do you have dental X-rays? Upload them here (optional, up to 4).

Almost done

Check that your phone and email are correct, so we can reach you before your appointment.

The information I provided is accurate, and I accept the Terms and Privacy Policy.

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