Virtual Appointment

Ortho360 offers Complimentary Virtual Consultations, that can be completed at home! Simply answer a few questions about your smile, upload photos of your teeth and our doctors will review your submission. Once reviewed, we’ll provide you with treatment options, pricing and next steps.

    Name (First and Last):

    Date of Birth:

    Address (City and Province):

    Email:

    Phone #:

    Preferred method of contact:
    PhoneEmail

    Click video to see how to take photos for upload

    Importation of photo (5mb file size max):

    Frontal

    Frontal Smile

    Frontal: (Drop your photo) [mfile FrontalSmileProfile filetypes:gif|png|jpg|jpeg max-file:10]

    Frontal Smile Example

    Frontal Smile

    Frontal Smile: (Drop your photo) [mfile FrontalSmileProfile filetypes:gif|png|jpg|jpeg max-file:10]

    Profile Example

    Profile

    Profile: (Drop your photo)[mfile Profile filetypes:gif|png|jpg|jpeg max-file:10]

    Center Biting Example

    Center Biting

    Center Biting: (Drop your photo) [mfile CenterBiting filetypes:gif|png|jpg|jpeg max-file:10]

    Right Side Example

    Right Side

    Right Side: (Drop your photo) [mfile RightBuccal filetypes:gif|png|jpg|jpeg max-file:10]

    Left Side Example

    Left Side

    Left Side: (Drop your photo) [mfile LeftBuccal filetypes:gif|png|jpg|jpeg max-file:10]

    Upper Teeth (occlusal) Example

    Upper Teeth (occlusal)

    Upper Teeth (occlusal): (Drop your photo) [mfile UpperOcclusal filetypes:gif|png|jpg|jpeg max-file:10]

    Lower Teeth (occlusal) Example

    Lower Teeth (occlusal)

    Lower Teeth (occlusal): (Drop your photo) [mfile LowerOcclusal filetypes:gif|png|jpg|jpeg max-file:10]

    What about your teeth would you like to fix?

    Do you visit a dentist regularly? If yes, what is their name?:

    When was your last dental visit?:

    Regarding Orthodontic Treatment, which is the most important to you:

    CostSpeedAesthetics