5-Step Smile Assessment - Kurpis Center For Implant and Cosmetic Dentistry

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Cosmetic Dentistry
Full Reconstruction
Underbite Correction
Dental Implants
Second Opinion
Periodontal Treatment
ABOUT DR. KURPIS
ABOUT THE KURPIS CENTER
201-447-9700
Patient Forms

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Step 1 of 5

What would you like to improve about your smile? *I hide my smile in photosI feel my smile makes me look olderMy teeth are worn, chipped, or breakingMy teeth are crooked or unevenMy teeth are dark or stainedI have missing teethI have old dental work I dislikeI have trouble chewing comfortablyMy bite feels wrongI want a complete smile transformationI'm not sure — I need guidanceOther

Step 2 of 5

What would changing your smile mean to you?Smile confidently againLook youngerFeel more attractiveImprove my professional appearanceStop worrying about my teethEat comfortably againImprove my overall quality of life

Step 3 of 5

Where are you in your smile journey?I'm exploring my optionsI know I want to improve my smileI've been thinking about this for yearsI've already had a consultation elsewhereI was told my case is complicatedI want a second opinion before making a decision

Step 4 of 5

What has prevented you from moving forward?Finding a dentist I trustFear of making the wrong decisionConcern about costDental anxiety or past bad experiencesWorried treatment will take too longUnsure which option is right for meNothing — I'm ready to begin

Step 5 of 5Request Your Personal Smile Evaluation

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Preferred contact:

When would you ideally like to begin?As soon as possibleWithin 30 daysWithin 3 monthsJust gathering information

✓ Over 50 Years of Cosmetic & Implant Experience
✓ Complex Cases Welcome
✓ Second Opinions Welcome
✓ Personalized Treatment Recommendations

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Cosmetic Dentistry
Full Reconstruction
Underbite Correction
Dental Implants
Second Opinion
Periodontal Treatment
ABOUT DR. KURPIS
ABOUT THE KURPIS CENTER
201-447-9700
Patient Forms

facebook
pinterest
youtube
instagram
phone