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๋ฌด๋ฃŒ ์ƒ๋‹ด ์น˜๊ณผ ์ž„ํ”Œ๋ž€ํŠธ ์„ค๋ฌธ์ง€

Personal Information

Are you California resident?
California
Out of state
Please confirm our location
1. How did you hear about us?
Friend / Family
Google AD
Online Search
Social Media
Other

Your Dental Concerns

Please choose the dental service you're interested in
2. What brings you in today? (Check all that apply)
3. How long have you had this concern?
Less than 1 year
1 ~ 3 years
Over 3 years
4. Have you had dental implants before?
Yes
No

Health Information

5. Do you have any medical conditions we should know about (e.g., diabetes, heart disease)?
Yes
No
6. Do you smoke or use tobacco? *
Yes
No

Goals and Questions

7. Whatโ€™s your main goal for dental implants?
Chew better / Eat comfortably
improve my smile
Replace dentures
8. What is the best time to reach you? (Check all that apply)
10. When are you wanting to start your treatment?
ASAP
Soon
I'm flexible
Not sure, I am still doing my research

 ์ž„ํ”Œ๋ž€ํŠธ๋ฅผ ์œ„ํ•œ 3D ์Šค์บ”์„ ๋ฐ›์œผ์„ธ์š”
์ตœ์ฒจ๋‹จ ๊ธฐ์ˆ ์„ ๋ฌด๋ฃŒ๋กœ ๊ฒฝํ—˜ํ•ด๋ณด์„ธ์š”!

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