FREE E-CONSULTATION FORM
​Please follow the instructions to submit the 5 required photos. If you prefer, you can also send us the photos to info@lineaclear.com.
Upload your pictures
1. Front smile
Upload a picture of your full smile from the front, as shown on the example


2. Right side smile
Upload a picture of your smile from the right side, use your hand as shown on the example. Make sure your upper and lower teeth are touching.


3. Left side smile
Upload a picture of your smile from the left side, use your hand as shown on the example. Make sure your upper and lower teeth are touching.


4. Upper smile
Upload a picture of your upper smile as shown on the example


5. Lower smile
Upload a picture of your lower smile, as shown on the example


Title
Firstname
City
Lastname
Country
Age
Phone
Have you seen a dentist for an examination and dental x-rays in the last 6 months and declared healthy?
Do you have any bridges or implants on your teeth?
Do you have any wobbly or loose teeth?
I agree to the terms of use
Please ensure that you have completed all of the required steps

Your images have been submitted, we will get back to you in 2 to 3 working days. For any query please reach out to us at info@lineaclear.com