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1. What is your biggest concern with your teeth?
I'm embarrassed to smile
I always have to use a toothpick because food gets stuck
They are crooked
Something else
2. Are you worried about feeling uncomfortable with the look of traditional metal braces?
Yes
No
3. What would be the biggest benefit if we could help you straighten your teeth?
I could smile with confidence again
I would not have to worry about my teeth cracking
I would be able to be healthier because I could better clean my teeth
4. If you could fit ClearCorrect (Clear Aligners) into your budget, are you ready to start right away?
Yes
No
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6619 B Airline Drive
Metairie, LA 70003
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