Mini Consultation

Welcome to kelsham’s free mini consultation. So we get to know you better and know what your main concerns are please could you complete the brief form below and follow the photo instructions so they can be downloaded to Kelsham Dental Care.

Please also enter your main concerns and what changes you would like to make to your teeth and smile.

Once we have received all your information we will then be able to advise you of what possible options are available to you. This will help allocate the most suitable Dentist for you needs when you are ready to visit Kelsham Dental Care.

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Personal Information

Pre-consultation Request

What treatment are you interested in

uploading photos

1: Nice full natural smile from the front and the left and right side.

2: a. Have your lips nice and wide apart showing your upper and lower teeth with a slight gap between them and make sure they do not touch.

b. With lips nice and wide apart, bite together so all your teeth meet

3: Open wide, head up for upper and down for lower teeth

Please note: All photographs submitted to us will be kept strictly confidential and not shared with any third party.

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Please be patient when submitting large images. We will redirect you to a confirmation page after this form has been processed.

Kelsham Dental Care The Common Cranleigh Surrey GU6 8SN T: 01483 274552 F: 01483 272492 E: Privacy
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