New Patient Assessment Form
ART Orthodontics | Dr Khatami | Davie Fl

Welcome to ART Orthodontics NEW PATIENT submission form. We are piloting this project to help prospective patients get information about their potential orthodontic treatment quickly and efficiently. We will do our best to have the information as helpful as possible. By uploading photos and giving us a quick dental history, we are able to give you an idea of treatment options; including an estimate of treatment times and costs. This is a very general estimate and we would follow-up with a consultation to explain the options and costs. A final treatment plan would be done in-office and that is when the final cost and payment options are determined. The form below is HIPAA-compliant and the images are securely saved on our server. We will delete all images after we follow-up. If the images are not diagnostic, we will follow-up and explain our options to you.

Photograph Instructions

This is an example of a composite of photos that would help to asses your treatment options. The pictures of the side and front bites have the cheeks retracted and a spoon can be used.

Individual photographs can be uploaded using the fields below.

For many bite corrections, an assessment of the position of the jaws is necessary and we would take x-rays to fully assess this.

For the purpose of estimating your treatment options – it is helpful (but not necessary) to upload images of your facial profile and smile.

Photos Courtesy of Dolphin Imaging

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