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1. What is the biggest problem that you’re having with your teeth right now:*
I'm missing 1-2 teeth
I’m missing more than 2 teeth
I want to get rid of my denture
I need to have 1 or multiple teeth removed
2. Why haven’t you fixed the problem yet?
I haven’t found a dentist I trust
I haven’t had time
The solutions I’ve found are too expensive
3. What would be the biggest benefit if we could help you fix this problem?
I could smile with confidence again
I could eat normally again
My teeth wouldn’t hurt anymore
4. If you could fit implants into your budget are you ready to start right away?
Yes
No
Elements Dental of Johnstown
848 W Coshocton Street
Johnstown, OH 43031
(614) 741-1070
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