Thank you for connecting with us. We will respond to you shortly.
1
1
https://onedayclinic.net/wp-content/plugins/nex-forms-express-wp-form-builder
false
message
https://onedayclinic.net/wp-admin/admin-ajax.php
https://onedayclinic.net/cosmetic-consultation-form
yes
1
fadeIn
fadeOut
Cosmetic Consultation
Our team is dedicated to giving you the smile you deserve.
Snap some photos of your smile.
Write a quick message
about your smile.
Get a video response
from the doctor.
Skip taking off work for that awkward first in-office consult. Get a Virtual Consult in three easy steps.
Start Your Virtual Consult
What are your main concerns?
Select all that apply
Missing teeth/ tooth
Alignment
Color
pain
Back
Next
What aspect of your life will fixing this problem affect?
Select all that apply
General health
Oral Health
Confidence
Speech
Ability to eat
Comfort
Back
Next
Are you a smoker?
Yes
NO
Back
Next
Do you have any of the following medical Conditions?
Any medical Condition is highly taken in consideration.
Diabetes
Hypertension
Bleeding problems
Previous Major health issues, Surgeries, hospitalization.
Currently taking any medications &/or supplement.
Previously taken any Bisphosphonates/antiresorptive, or antiangiogenic drugs.
Allergy to any medication.
Pregnancy.
Other
Kindly explain in details your current/ previous medical health situation ...
Back
Next
Tell us about you?
Whats your Name?
Date of birth?
How can our team reach you?
*Email:
*Phone Number:
Back
Next
Take a Picture of your teeth!
Assist with a spoon in Right & Left images. Upload at least one image for every position.
* EMPHASISE ON MISSING TOOTH SPACE
Top
gif jpg jpeg png psd tif tiff
Bottom
gif jpg jpeg png psd tif tiff
Right
gif jpg jpeg png psd tif tiff
Left
gif jpg jpeg png psd tif tiff
Back
Next
Last Step!
Help us understand your condition by telling us more about your problem (when have you lost your tooth, what you wish to change and whether you have had a previous procedure regarding the mentioned issue. (Optional)
Back
Submit
افتح المحادثة
تواصل معنا عبر ال Whatsapp
Welcome to OneDay Clinic
مرحبا بك في ONEDAY CLINIC اضغط علي زر "المحادثة" في الاسفل للمحادثة علي الواتساب او ارسل لنا بريد الكتروني علي
info@onedayclinic.net