Implant 2 – Klinik Pergigian DentalPark Kajang

Step 2: Answer The 9-Questions Survey Below To Secure Your Voucher

Kindly fill out this 9 question survey. This helps us better understand your current oral condition and how we can best help you.

Please Note: If you do not fill out the survey, we will not send you your free consultation voucher to cover the cost of your first appointment.

1. Which teeth problem are you experiencing?

Missing 1 Tooth Missing a few teeth My Denture Is Not Comfortable Difficult With Eating Food Other Problems

2. Which dental restoration do you currently have?

Denture Bridge, Crown Dental Implant None Of The Above

3. Do you currently have difficulty eating food?

Yes No

4. Is your current teeth condition causing you daily pain or discomfort?

Yes No

5. How long have your teeth been missing?

Less than 1 Year 1-5 Years More than 5 Years

6. Why didn't you get any treatment to replace the missing teeth?

Been To Other Dentists And They Were Too Expensive Fear Of Dental Procedures Haven't Found A Dentist I'm Comfortable With Other Reasons

7. We offer credit card installment plans 6 - 12 months for our customers too, are you interested with the installment plan?

Yes, I'm interested with the installment plan No, I prefer to pay full in cash.

8. Although the first appointment is free, we do expect new patients to respect our time and SHOW UP for their appointment. Do you commit to showing up for your appointment at the time it is scheduled?

Yes, I commit to showing up for my consultation on time. No, I cannot commit to showing up on time for my consultation.

9. What's Your Name Again?