- Dr G Dental

Leading Cosmetic Dentistry in Tenby, Pembrokeshire, South West Wales

Transforming Smiles in Tenby, South Wales

Croeso/Welcome!

At Dr G Dental, Dr Guto believes that a confident smile can change everything.

Please complete the following assessment to help me understand your smile goals and create a personalised treatment plan tailored to your needs.

Name

Number

Preferred Contact Method

Phone Email

What aspects of your smile would you like to improve?

Teeth Straightening Teeth Colour Teeth Shape Gaps Between Teeth Chipped or Broken Teeth

Other:

Have you undergone any cosmetic or orthodontic dental treatments in the past?

Yes No

If Yes, Please give Details of Past Treatments:

On a scale of 1 to 10, how satisfied are you with your current smile?

1 2 3 4 5 6 7 8 9 10

Are you interested in any specific treatments?

Invisalign (clear aligners) Porcelain Veneers Composite Bonding/Veneers Teeth Whitening

Other:

Do you have a specific event or timeframe for achieving your desired smile?

No specific timeframe Within 1-3 months Within 3-6 months Within 6-12 months

Other:

What is your budget range for cosmetic dental treatments?

£500 - £1,000 £1,000 - £3,000 £3,000 - £5,000 £5,000+ Unsure

Would you like to learn about our flexible payment plans?

Yes No

What has motivated you to consider improving your smile at this time?

Special occasion (wedding, event, etc.) Increased confidence in personal/professional life Long-standing dissatisfaction with my smile Recommended by a dentist/orthodontist

Other:

To provide a comprehensive assessment, please upload the following photos:

Photo 1: A full-face photo with a natural smile. Photo 2: A close-up of your smile showing your teeth clearly. Photo 3: A photo of your teeth biting together from the front.

How did you hear about us?

Instagram Facebook Google Search Referral

Other:

Facebook Icon-instagram-1

Leading Cosmetic Dentistry in Tenby, Pembrokeshire, South West Wales