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MAKE AN ENQUIRY

 We will give you an opinion about your orthodontic needs, treatment aims, brace options, costs, timescales and a written estimate.

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All fields MUST be completed. This will take you around 20 minutes to complete.

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For any other enquiries please email info@chichesterorthodonticclinic.co.uk

Your Details

Are you under any gum/perio treatment?
Do you have any outstanding dental treatment?

About Your Smile

Have you had braces before?
Rate your teeth out of 10 (1 being the worst)
What are your main concerns about your teeth?
Have you suffered any trauma to your teeth that required dental treatment?
Do you do any of the following?
Do you suffer from any of the following?

Upload images of your teeth (all required)

Photo 1.png
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Photo 2.png
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Photo 6.png
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Part open mouth.jpg
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Photo 3.png
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Photo 4.png
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Photo 5.png
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Hint: Please use your finger or a spoon to pull your cheek out of the way so we can see your how your back teeth fit together.

Photo 7.png
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Hint: Please use your finger or a spoon to pull your cheek out of the way so we can see how your back teeth fit together.

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