Cosmetic Dentistry Initial Consultation Form The Initial Consultation Form for Cosmetic Dentistry First Name * Last Name * Email Address * Cell # Communication Preference: Call Text Email Please Describe the Service You Desire: * What is Your Desired Appointment Date? Please note that your initial consultation for recommended cosmetic dentistry treatment and procedures has a fee of $99. However, if you choose to go ahead with enhancements, your first bill is credited $99, making the initial consultation no cost. When the form is complete, hit send and we’ll reply to you shortly. Thank you for choosing Cumming’s Family Dentist Captcha If you are human, leave this field blank. Send
