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Dentist in Campbell | Dental Clinic & Office |  Family Dentistry in Campbell

NEW PATIENT FORM

Patient Info
Upload Photos

If you can submit your photos, that will help us determine your treatment plan before your visit! When taking pictures, please use flash.

#1 Lower Teeth*

Open your mouth wide and tilt your chin down towards your chest. Hold the camera so it’s facing the biting surfaces of your lower teeth. Make sure your full arch is showing and then snap a picture.

Lower Teeth

#2 Upper Teeth*

Open your mouth wide and lift your chin as high as you can. Hold the camera so that it’s facing the biting surfaces of your upper teeth. Make sure you can see the full arch and then click.

Upper Teeth

#3 Front View*

Bite down so your back teeth touch completely. Facing the camera directly, use two fingers or spoons to pull your lips and cheeks away from your teeth. Smile wide, so you can fit as many teeth as possible in the picture and then click.

Front View

#4 Right View*

Open your mouth wide and tilt your chin down towards your chest. Hold the camera so it’s facing the biting surfaces of your lower teeth. Make sure your full arch is showing and then snap a picture.

Right View

#5 Left View*

Open your mouth wide and tilt your chin down towards your chest. Hold the camera so it’s facing the biting surfaces of your lower teeth. Make sure your full arch is showing and then snap a picture.

Left View