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?
