Free Virtual Orthodontic Consultation

We understand that your time is valuable, and making it into our office for a consult might be difficult. Wouldn’t it be nice to know if you are a candidate for orthodontic treatment before even walking through our door? Our Virtual Consultation makes that possible.

How it Works:

1. Ask someone to help you replicate the photos below using a digital camera or smartphone.

2. Submit all 5 of your photos using the form below and tell us about any concerns you have.

3. Dr. Akhavan will review your photos with you during your virtual appointment.

How to Photograph Your Smile

Photos should be taken in a seated position, in a room with good lighting. For best results, have someone else take the photos, as they can be difficult to take on your own. Please contact our office if you have any questions about this form.

"*" indicates required fields

Step 1 - Show Us Your Smile

Accepted file types: jpg, jpeg, gif, png, pdf, heic, heif, Max. file size: 64 MB.

Bite down on your regular bite with back teeth touching. Pull back your right cheek as far as you can. Snap picture looking directly at the right side of your mouth.

Accepted file types: jpg, jpeg, gif, png, pdf, heic, heif, Max. file size: 64 MB.

Bite down on your regular bite with back teeth touching and show us your biggest smile ever, showing as much of your teeth as possible. Snap picture looking straight at your smile.

Accepted file types: jpg, jpeg, gif, png, pdf, heic, heif, Max. file size: 64 MB.

Bite down on your regular bite with back teeth touching. Pull back your left cheek as far as you can. Snap picture looking directly at the left side of your mouth.

Accepted file types: jpg, jpeg, gif, png, pdf, heic, heif, Max. file size: 64 MB.

Tilt your head back and take a photo. Try to get your full arch. Face a window for the best lighting or use a flashlight to brighten the palate.

Accepted file types: jpg, jpeg, gif, png, pdf, heic, heif, Max. file size: 64 MB.

Tilt your chin down and take a photo. Try to get your full arch. Face a window for the best lighting or use a flashlight to brighten the tongue and back teeth.

Step 2 - How May We Contact You?

Patient Name*

Step 3 - What Is Your Goal With Treatment? *

Please wait for a confirmation message to ensure your photos have been uploaded, it may take a minute depending on image size and internet connection.

All data is for candidate orthodontic evaluation purposes only and does not constitute or replace a professional dental visit or exam. To receive top quality, professional advice with no obligation, book your free consultation today and one of our team members will call you to confirm. Any comments, feedback, questions, concerns, information, suggestions, submissions, and/or ideas you submit through or related to the Site (a “Submission”) may not be considered confidential by Next Level Orthodontics. You expressly acknowledge that Next Level Orthodontics reserves the right to republish any Submission and share any Submission, internally or externally. By making a Submission, you agree to grant Next Level Orthodontics a worldwide, exclusive, royalty-free, perpetual irrevocable license to reproduce, modify, use, and/or sublicense or assign such Submission in any manner whether or not related to the Site or Services. You acknowledge and agree that you are responsible for the Submissions that you provide, and that you have full responsibility for the Submissions, including their content, legality and/or any intellectual property contained therein. By making a Submission, you agree you have the right to make said Submission and that it will be free of any claims from any third party. You further agree that you are solely responsible for any claims related to or arising out of such Submission and you agree that you will hold Next Level Orthodontics harmless relating to any such claim.