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1. Is this for you or someone else?

Myself

Someone else

2. What's your age?

Under 12 years old

12-17 years old

18-24 years old

25-34 years old

35-44 years old

45 years old and above

3. Have you had a dental procedure with sedation before?

Yes

4. How would you describe your current dental concerns or needs?

I need multiple procedures and want them completed in fewer visits.

I have anxiety about dental visits and want a stress-free experience.

I have sensitivity or a strong gag reflex and need a more comfortable solution.

I want a more relaxing, efficient dental care experience.

What is your time frame to fix your teeth?

Less than 6 months

6 months to 1 year

1 to 2 years

Over 2 years

Why now? What made you take the step now?

I’ve been avoiding dental care due to fear or anxiety, and it’s starting to affect my oral health.

I have a busy schedule and want to complete multiple treatments in as few visits as possible.

I want to feel more confident about my smile and overall dental health.

I’ve heard great things about sedation dentistry and want to try it for a more comfortable experience.

If we need to fit this into your budget, how can we make it affordable for you?

Monthly payment plans

Flexible treatment options

Assistance with dental benefits

Referral credit for bringing new patients

Fabulous Dentistry

9863 Long Point Rd Houston Tx 77055

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