Orthodontic Virtual Visit

Complete Your Orthodontic Virtual Visit!

Please complete the information below for Dr. Frazier and her team to review. For photo instructions,  click here ! If you are an aligner patient, please wear your aligners while taking the first photo only. Then remove your aligners for the other photos. If you are completing a retainer check, please wear your retainers while taking the first photo only, then remove your retainers for the other photos.

Virtual Visit

First Name *

Last Name *

Email *

Phone *

Date of Birth *

Preferrer Method of Communication * Preferrer Method of Communication *PhoneEmailText Message

If you are an aligner patient, what number aligner are you on?

How many days have you been in this aligner?

Do you have any additional information that you'd like to send Dr. Hopkins at this time?

Upload Photos

2 Spoons & Cell Phone Camera. If you are an aligner or retainer patient, please wear your aligners or retainers for the first smiling photo only. Then remove your aligners for the other photos.

#1 Smiling *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Please wear your aligners/retainers for this photo only. Look straight at the camera and open slightly, so that we can see your top and bottom teeth.

#2 Lower Teeth *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Open your mouth wide and tilt your chin downwards toward your chest. Hold the camera so it’s perpendicular to the biting surfaces of your bottom teeth. Make sure your full arch is showing and then snap a picture.

#3 Upper Teeth *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Open your mouth wide and lift your chin as high as you can. Hold the camera so that it’s perpendicular to the biting surfaces of your top teeth. Make sure you can see the full arch and then click.

#4 Front View *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Bite down so your back teeth touch. Smile wide and pull your lips and cheeks away from your teeth with 2 spoons so that you show more teeth. You may need a friend to help take this photo so that you can pull your cheeks away with the spoons.

#5 Right View *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Bite down so that your back teeth touch, smile and retract the cheek and lips with a spoon on the right side of your mouth to expose more of your teeth. Take a picture of the right side.

#6 Left View *

Drop a file here or click to upload Choose File

Maximum file size: 1MB

Bite down so that your back teeth touch, smile and retract the cheek and lips with a spoon on the left side of your mouth to expose more of your teeth. Take a picture of the left side.

If you are human, leave this field blank.

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