Belur Orthodontics: INVISALIGN OPEN MONTH EVENT ON APRIL 2022, BOOK NOW !!!! ONLY 10 MORE PLACES.

Patient Expectations Questionnaire

    Are you currently:Yes / No
    Too Small Or Short?YesNo
    Too Large Or Large?YesNo
    Crooked/Crowded Or Overlapped?YesNo
    Do You Feel You Front Teeth "Stick-Out" Too Much?YesNo
    Misshaped?YesNo
    Are There Spaces Between Your Teeth That You Do Not Like?YesNo
    Face: are you happy with your:Yes / No
    LipsYesNo
    NoseYesNo
    Jaws / Jaw LineYesNo
    OtherYesNo
    Symptoms: if you want to reduce pain or discomfort, where is it located?Yes / No
    In Front Of My EarsYesNo
    INear My EarsYesNo
    Neck / ShouldersYesNo
    TemplesYesNo
    EyesYesNo
    TeethYesNo
    SinusesYesNo

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