June 9, 2024 – FoX Dental Implant Centres

What Best Describes Your Condition? *

I Have All My TeethI'm Missing One ToothI'm Missing Multiple TeethI'm Missing All My Teeth

How Long Have You Been Missing Your Teeth? *

I'm Not Missing TeethLess Than A YearMore Than A Year

Are you currently wearing dentures? *

YesNo

What made you reach out to our office? *

Tooth PainMissing TeethInsecurities about the way you lookAll of the above

Select All That Apply - Do You Feel That Tooth Loss Has Affected Your: *

Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods? *

YesNo

What Is The Most Important Outcome You Are Seeking? *

Function - Eating, Chewing, TalkingAesthetics - Beautiful, Natural Looking TeethBoth Are Equally As Important

What Is The Most Important Factor That Has Prevented You From Getting Treatment? *

TimeMoneyFearCan't Find The Right Dentist

Please Describe your current Oral Health situation and the challenges that you are Experiencing. *

What is your timeline to receive treatment? *

Very little, I'm in no rushModerate, Within 1-3 monthsHigh, I need help now

Have you seen another dentist about your condition? *

No, This is my first consultationYes, I did not feel comfortable with the other practiceYes, I'm looking to compare pricing

If this is a second opinion what type of implant solution are you looking for? *

Fixed Full ArchSingle ImplantTraditional DentureNot Sure

Are You The Decision Maker In Regards To Your Dental & Healthcare? *

YesNo

Most Dental Implant procedures are not covered by insurance. However we offer many payment plans that make it quite affordable and offer low monthly rates. Are you interested in a payment plan? *

Yes I am!No I will not need a payment plan

Are You Interested in Learning About Our Easy Monthly Payment Plans? If So, What Dollar Range Would You Like To Pay Monthly *

How Familiar are you with the "All-On-4" treatment? Scale of 1-10 *

Do you consent to receive texts and emails regarding Dental Implant treatments and the prices associated? *

Yes send me the informationNo, I do not wish to receive information regarding pricing for dental implants

By selecting no, we want to make sure that you are aware that we will not be able to provide you with the pricing and information you have requested regarding Dental Implants, immediately. We will reach out via a phone call but if you would like an email and text regarding pricing, please opt-in below. *

Yes I consent to receive this informationI would like to schedule an appointment to talk in personI would like to speak to someone via phone call to discussI do not want this information

First Name *

Last Name *

Phone *

Email *

Postal Code *

Which Location Is Most Convenient For You? *

Melbourne - 3-5 Loughnan Road Ringwood, VIC 3134Brisbane - Suite 16/261 Given Terrace Paddington, QLD 4064Adelaide - Suite 5B Station Arcade, 136 North Terrace Adelaide, SA 5000

Understanding All on 4 Dental Implants: An In-depth Guide in Australia

Get implant pricing and financing options,
Including your superfund!

Find Out If You're A Candidate!

What Best Describes Your Condition? *

How Long Have You Been Missing Your Teeth? *

Are you currently wearing dentures? *

What made you reach out to our office? *

Select All That Apply - Do You Feel That Tooth Loss Has Affected Your: *

Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods? *

What Is The Most Important Outcome You Are Seeking? *

What Is The Most Important Factor That Has Prevented You From Getting Treatment? *

Please Describe your current Oral Health situation and the challenges that you are Experiencing. *

What is your timeline to receive treatment? *

Have you seen another dentist about your condition? *

If this is a second opinion what type of implant solution are you looking for? *

Are You The Decision Maker In Regards To Your Dental & Healthcare? *

Most Dental Implant procedures are not covered by insurance. However we offer many payment plans that make it quite affordable and offer low monthly rates. Are you interested in a payment plan? *

Are You Interested in Learning About Our Easy Monthly Payment Plans? If So, What Dollar Range Would You Like To Pay Monthly *

How Familiar are you with the "All-On-4" treatment? Scale of 1-10 *

Do you consent to receive texts and emails regarding Dental Implant treatments and the prices associated? *

Which Location Is Most Convenient For You? *

Understanding All on 4 Dental Implants: An In-depth Guide in Australia

Get implant pricing and financing options, Including your superfund!

Find Out If You're A Candidate!

What Best Describes Your Condition? *

How Long Have You Been Missing Your Teeth? *

Are you currently wearing dentures? *

What made you reach out to our office? *

Select All That Apply - Do You Feel That Tooth Loss Has Affected Your: *

Does Your Condition Have A Negative Impact On Your Ability To Eat or Chew Certain Foods? *

What Is The Most Important Outcome You Are Seeking? *

What Is The Most Important Factor That Has Prevented You From Getting Treatment? *

Please Describe your current Oral Health situation and the challenges that you are Experiencing. *

What is your timeline to receive treatment? *

Have you seen another dentist about your condition? *

If this is a second opinion what type of implant solution are you looking for? *

Are You The Decision Maker In Regards To Your Dental & Healthcare? *

Most Dental Implant procedures are not covered by insurance. However we offer many payment plans that make it quite affordable and offer low monthly rates. Are you interested in a payment plan? *

Are You Interested in Learning About Our Easy Monthly Payment Plans? If So, What Dollar Range Would You Like To Pay Monthly *

How Familiar are you with the "All-On-4" treatment? Scale of 1-10 *

Do you consent to receive texts and emails regarding Dental Implant treatments and the prices associated? *

Which Location Is Most Convenient For You? *

Get implant pricing and financing options,
Including your superfund!