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免费咨询 植牙问卷

Personal Information

1. How did you hear about us?
Friend / Family
Google AD
Facebook
Online Search
Social Media
Other

Your Dental Concerns

Please choose the dental service you're interested in
2. What brings you in today? (Check all that apply)
3. How long have you had this concern?
Less than 1 year
1 ~ 3 years
Over 3 years
4. Have you had dental implants before?
Yes
No

Health Information

5. Do you have any medical conditions we should know about (e.g., diabetes, heart disease)?
Yes
No
6. Do you smoke or use tobacco? *
Yes
No

Goals and Questions

7. What’s your main goal for dental implants?
Chew better / Eat comfortably
improve my smile
Replace dentures
10. When are you wanting to start your treatment?
ASAP
Soon
I'm flexible
Not sure, I am still doing my research
11. Booking
I'll book now
Schedule after a phone consultation with consultant, skip the booking.
Schedule an appointment
2025年5月
日一二三四五六
Week starting 星期日, 5月4日
時區: 协调世界时 (UTC)商家地點
5月5日星期一
10:00 - 11:00
11:00 - 12:00
12:00 - 13:00
13:00 - 14:00

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 对你的植入物进行 3D 扫描
免费体验尖端技术！

Contact us

Our contact form is temporarily unavailable. Please email us directly if you have any questions or inquiries. Thank you for your understanding!

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