FREE CBCT Scan (Dental Cone Beam Tomography) & Consultation

Complete this short 1 minute quiz and receive a **FREE CBCT Scan (Dental Cone Beam Tomography) & Consultation at our Lone Tree Location! Pressure, Risk & Anxiety Free!** This is a $650 VALUE at NO Charge to you!

Step 1 of 3

• What is your biggest dental challenge? (Select all that apply) * I am missing a single tooth I am missing multiple teeth I am struggling with my traditional dentures Most of my teeth are broken, decayed or missing
• How long have you been struggling with this?* * Select One Less Than 1 Month Less Than Six Months Less Than 1 Year More Than 1 year
• What has kept you from fixing your smile? (Select all that apply) * Nothing! I am ready right now. Cost of dental procedures Fear of dental procedures Time involved in dental procedures Have not found a dentist that I am comfortable with yet
• If it was affordable, how soon would you be ready to move forward with treatment? * Select One In the next 30 days In the next 6 months I am in no rush, just researching options

• I am missing a single tooth
• I am missing multiple teeth
• I am struggling with my traditional dentures
• Most of my teeth are broken, decayed or missing

• Nothing! I am ready right now.
• Cost of dental procedures
• Fear of dental procedures
• Time involved in dental procedures
• Have not found a dentist that I am comfortable with yet

• How do you plan to pay for your dental implant treatment? (Select all that apply) * Cash Credit Card Dental Insurance (please note: Medicare / Medicaid not accepted) Healthcare Financing (CareCredit, GreenSky) I would like to learn more about financing options / payment plans
• Select the option that best describes your situation. * Select One I can afford monthly payments of $150 - $399 and have money to put down I have a set amount of cash that I can spend and need help finding a treatment plan that fits my budget I am prepared to pay for my entire treatment up front I do not currently have any money to afford treatment
• Have you spoken to another dentist about treatment? * Select One Yes, I would like a second opinion. No, This will be my first consultation.
• What was the price range of the other dentist’s treatment plan? * Select One $500.00 - $2,000.00 $2,000.00 - $5,000.00 $5,000.00 - $10,000.00 $10,000.00 - $20,000.00 $20,000.00 - $30,000.00 more than $30,000.00
• What is most important to you about your implant dentist? (select all that apply) * Lowest cost Experience placing implants Delivers highest quality Financing options Gentle and Caring

• Cash
• Credit Card
• Dental Insurance (please note: Medicare / Medicaid not accepted)
• Healthcare Financing (CareCredit, GreenSky)
• I would like to learn more about financing options / payment plans

• Lowest cost
• Experience placing implants
• Delivers highest quality
• Financing options
• Gentle and Caring

• How did you hear about us? * Internet Search Facebook - Instagram Referral from another doctor Print Ad
• Are You Ready To Take The First Step To Change Your Life And Schedule Your FREE Consultation? * Select One Yes No
• Name * First Last
• Email *
• Phone *
• What is your zip code? *

• Internet Search
• Facebook - Instagram
• Referral from another doctor
• Print Ad