Awesome, here’s your next step!

You’ve taken the 1st step to determine if Dental Implants are right for you!

We just texted and emailed your Dental Implant Information & Pricing Guide you. Here’s your next step:

Watch: Our NEW Video Explains What Dental Implants REALLY Are And What Options Are Available To You.

Now that you know your options, complete this short evaluation to see:

1. If YOU are eligible for dental implant treatment

2. Which Treatment would be best for YOU

3. General Pricing!

Which condition best describes you? *

I have 1 tooth missing

I have multiple teeth missing

I'm missing all of my teeth or most of my teeth

I'm Struggling With Traditional Dentures

Do you currently have any of these dental solutions? *

Denture or Partial Denture

Bridge, Crown

Dental Implant

None of the above

How Long Have You Been Missing Your Teeth? (The longer teeth are missing the more the jaw bone shrinks) *

I Still Have Them

1-6 Months

7-12 Months

1+ Years

6+ Years

Which of the following are you experiencing? (Check all that apply)

Unable To Eat Certain Foods

Have To Modify The Way You Chew

Pain Or Discomfort

A Lack Of Confidence In Social Situations

Find Yourself Hiding Your Smile

All of the Above

Dental Implants are generally not covered by insurance. However, many affordable payment plan options exist. Are you interested in a payment plan option? *

Yes. I'm interested in affordable payment plan options

No. I will not need a payment plan

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

(Very Poor) Under 500

(Poor) 501-600

(Good) 601-649

(Very Good) 650-699

(Excellent) 700+

I don't know

Based on your credit score you may not qualify for financing without a co-signer. Do you have someone with good credit history who would co-sign with you? *

Yes

No

Unfortunately it looks like you would not be able to qualify for our payment plan options. Do you have any other way to pay for a Dental Implant procedure? *

Savings

Credit Card

Retirement Account (401k, etc)

Other loan (Home Equity, etc)

Help from a relative

No, I don't

How Ready Do You Feel To Do Something About Your Situation? *

Somewhat Ready

Very Ready

I Need Something FAST!

What Is Your Name? *

What Is Your Best Email Address? *

What Is Your Best Phone Number? *

UTM Source

UTM Keywords

Setter Center?

VTC?

Form type

Ortho Offer

Here's What Your Neighbors Are Saying About Bergenfield Dental...

Complete the Evaluation Above to:

1. See If You’re a Candidate

2. Learn What Treatment Would Be Best For You

3. Know Your Pricing Options

HOME | TERMS AND CONDITIONS | ACCESSIBILITY STATEMENT

Copyright © 2021 Local Dental Implants | All Rights Reserved

*Subject to down payment and credit approval. Financing terms subject to change without notice.