Find Out If You're A
Candidate For Dental Implants!

I Have All My Teeth

I'm Missing One Tooth

I'm Missing Multiple Teeth

I'm Missing All My Teeth

I'm Not Missing Teeth

Less Than A Year

More Than A Year

Personal Life

Professional Life

Enjoyment of Food

Physical Comfort

Appearance/Self Confidence

Can't Find The Right Dentist

No, This is my first consultation

Yes, I did not feel comfortable with the other practice

Yes, I'm looking to compare pricing

Fixed Full Arch

Implant Supported Denture

Single Implant

Traditional Denture

No I will not need a payment plan

No, I will not need a payment plan

$150-$249/Month (For Single Implant)

$250-349/Month

Over $350/Month

No, I do not have Medical Insurance

First Name *

Mobile (Cell) Number *

Postal Code *

Find Out If You're A
Candidate For Dental Implants!

Find Out If You're A Candidate For Dental Implants!

Answer The Following Questions To Learn More About Our Pricing & Financing Options

What Best Describes Your Condition? *

How Long Have You Been Missing Your Teeth? *

Are you currently wearing dentures? *

What made you reach out to our office? *

Select all that apply - Do you feel that tooth lose has affected your: *

Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods? *

What Is The Most Important Outcome You Are Seeking? *

What Is The Most Important Factor That Has Prevented You From Getting Treatment? *

Please Describe your current Oral Health situation and the challenges that you are Experiencing. *

What is your timeline to receive treatment? *

Have you seen another dentist about your condition? *

If this is a second opinion what type of implant solution are you looking for? *

Are You The Decision Maker In Regards To Your Dental & Healthcare? *

Most Dental Implant procedures are not covered by insurance. However we offer many payment plans that make it quite affordable and offer low monthly rates. Are you interested in a payment plan? *

Are You Interested in Learning About Our Easy Monthly Payment Plans? If So, What Dollar Range Would You Like To Pay Monthly (Upon Approval Third Party Financing) *

Some medical insurance plans may cover Full-Arch dental implant treatment. Do you have a medical insurance plan? *

How Familiar are you with the "All-On-4" treatment? Scale of 1-10 *

Burr Ridge Office

Mount Prospect Office

Roselle Office

Please Choose Your Preferred Location

Find Out If You're A
Candidate For Dental Implants!