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Grown-Up Survey

With the addition of our new Teen expansion we are also adding space in our schedule to allow parents to be seen right along side their teens! This service is described as Adult Preventative Dentistry, since we will not be set up to handle the more complicated cases. This survey will help us to establish if we are a good fit for your own dental care.

Do you want to change the way your teeth look?
Do you have a bridge?
Do you have dentures?
Do you have TMD/TMJ (jaw pain)?
How long since your last cleaning?
Do you have any crowns in your mouth?
How many crowns?
What kind of crowns?
Have you been to a periodontist (gum specialist)?
How long ago?
Have you been to a endodontist (root canal specialist)?
Do you have any root canals?
How many root canals?
How long ago?

Thank you for your interest! We will contact you within 2 business days.

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