Virtual Consultation

Steps to take for a
Free Virtual Consultation

For us to give you the best consultation possible we are asking that our patients provide us 3 pictures prior to our consultation. We will be requiring a front smile, a side profile, and a wide-open smile picture as seen below. Please provide these images in the form below when signing up.

Image 1: Front Facing Smile

Image 2: Side Profile

Image 3: Wide Smile Showing Both Rows Of Teeth

Virtual Consultation Form

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Best time for Dr. to call you

Best date for Dr. to call you

Virtual Image Upload Section

Upload Virtual Image #1

Please provide us with the FIRST dental image that we requested above on this page.

Max. file size: 512 MB.

Upload Virtual Image #2

Please provide us with the SECOND dental image that we requested above on this page.

Max. file size: 512 MB.

Upload Virtual Image #3

Please provide us with the THIRD dental image that we requested above on this page.

Max. file size: 512 MB.

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Welcome to Imagination Orthodontics our rebrand of Braces at Brick, where our passion is to create confident smiles that last a lifetime.

Virtual Consultation Form

Virtual Image Upload Section

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