Free Online Smile Assessment

Five Smile Rated

Fill out the form below and
upload your pictures.

Click or drag files to this area to upload. You can upload up to 8 files.

You’re done!

Dr Emily Willett

Dr. Willett will now assess your photos and our office will email you the assessment and fees. We will then contact you to schedule a consultation with Dr. Willett and our treatment coordinator. At this consultation, we will review your orthodontic needs, treatment options and treatment fees with payment plans. We look forward to meeting you soon!

VERY IMPORTANT:

When we send you an email, or you send us an email, the information sent is not encrypted. That means a third party may be able to access the information and read it since it is transmitted over the Internet. If you receive an email, someone may be able to access your email account and read it.

  • HIPAA stands for the Health Insurance Portability and Accountability Act
  • HIPAA was passed by the U.S. government in 1996 in order to establish privacy and security protections for health information
  • Information stored on our computers is encrypted.
  • Most popular email services (ex. Hotmail®, Gmail®, Yahoo®) do not utilize encrypted email.
  • Email is a very popular and convenient way to communicate for a lot of people, so in their latest modification to the HIPAA act, the federal government provided guidance on email and HIPAA.
  • The guidelines state that if a patient has been made aware of the risks of unencrypted email, and that same patient provides consent to receive health information via email, then a health entity may send that patient personal medical information via unencrypted email. Read more information.

By requesting a virtual consultation through email you’re accepting the terms and conditions of utilizing non-encrypted email to communicate health information.

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