See what your smile looks like after Lumiliner treatment!

Fill out the form and find out if Lumiliner treatment is right for you. We recommend filling out the form on a mobile device, as a successful treatment assessment requires photos of your teeth.

If you don’t want to send us your pictures, no worries! You can contact us through the traditional form.

Continue with the consultationSend contact information

Fill out the 4-step virtual treatment evaluation form and upload photos of your teeth.

Submit the information to our treatment coordinator for review.

Receive a customized report of your teeth and an assessment of the effects of Lumiliner treatment on your smile.

The information and photos you provide will only be processed by our treatment coordinator and dental clinic staff. We will never pass on your information or use it for marketing purposes.