Brudee Aligners Assessment - Brudee Oral Care

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First Name(Required)

Last Name(Required)

What’s your email?(Required)

What’s your contact number?(Required)

My WhatsApp number is different from my local mobile number

How can we contact you to follow up on treatment?

Choose location(Required)

(Required)

I agree to be contacted by Brudee via WhatsApp and other channels

Why are you thinking about straightening your teeth?(Required)

Other

Have you worn braces or invisible aligners in the past?(Required)

YES

Choose the option that best describes your biggest concern with your smile(Required)

How would you describe your teeth?(Required)

Crowding teeth

Protruding teeth

Gaps in teeth

Crooked teeth

I'm not sure

Bite down naturally on your back teeth and smile wide! Use the white lines as a guide.(Required)

Max. file size: 256 MB.

Bring your phone up, open wide, and show your bottom-front teeth by keeping lips away. Use the white lines as a guide.(Required)

Max. file size: 256 MB.

Tilt your phone down, open wide and show your upper-front teeth by keeping lips away. Use the white lines as a guide.(Required)

Max. file size: 256 MB.

Turn your head to the side and clench evenly on your back teeth. Smile big! Use the white lines as a guide.(Required)

Max. file size: 256 MB.

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