Step 1. Photos saved on your phone/computer
Before beginning this form, please take photographs on your mobile phone.
(Optional, but preferred method of assessment)
- Patient’s upper right back teeth
- Patient’s upper left back teeth
- Patient’s lower left back teeth
- Patient’s lower right back teeth
- Front teeth with lip lifted
PLEASE NOTE: After completing and submitting this form please call 08 84316162 to arrange a 30 minute Teleconsultation with you and your child. Please be advised a fee of $55 may apply, private health insurance rebates may not be applicable at this time.