Eligibility Quiz | AboutFace

ARE YOUR ELIGIBLE FOR IMPLANTS

How would you describe your current dental health?

Missing one tooth

Missing multiple teeth

Broken, cracked, or loose

Periodontal disease

Do you currently have any of these dental appliances?

Denture or partial denture

Bridge, Crown

Dental implants

None of the above

Payment plans are available based on credit approval of the patient or co-signer. What best describes your credit?

(Poor) Under 600

(Fair) 660 - 699

(Good) 700 - 739

(Excellent) 740+

Which best describes your household monthly income?

Under $5,000

$5,000 to $10,000

Over $10,000

Are you interested in any affordable payment plan options?

Yes, I am interested in an affordable payment plan option.

No, I will not need a payment plan.

I will need a co-signer.

What is your first name?

What is your last name?

Date of Birth

What is your best email?

What is your best phone number?

Street Address

City

State

Zip Code